Relationship between Coronal Alignment and Posterior Tibial Slope in the Lower Extremity

Serhat Mutlu,Harun Mutlu,Atilla Parmaksizoglu,Olcay Guler,Gokhan Ozkazanli

doi:10.4236/ojo.2014.44016

Abstract

Purpose: To restore the normal axial alignment of the lower extremity is important in reconstructive knee surgery. The aim of this study was to evaluate lower-limb alignment and posterior tibial slope. Methods: Thirty-two male and 32 female outpatients aged 22 to 46 were recruited. A full weight-bearing anteroposterior radiograph of the entire lower limb was obtained for each subject. The axial alignment was measured based on the centers of the femoral head, knee, and ankle. The tibiofemoral (TF), tibial joint (TJ), and posterior tibial slope (TS) angles were determined. Results: The mean TF angle was more varus in women (177.8°) than men (179.2°), and the mean TJ angle was more medially inclined in women than men. Women had a greater TJ angle than men (93.3° vs. 91.6°). The mean posterior TS was greater in men than women (16.0° vs. 12.5°, p < 0.05), while the mean TS angle was greater in women (14.8°) than men (12.3°). Conclusion: Knee alignment and geometry vary among populations. In our study, the TF angle was varus among all participants. The knee joint was more medially inclined in women than men. And also the posterior TS was greater in women than men.

Highlights

Restoration of the neutral mechanical alignment of the lower limb in the coronal plane and the correct rotational alignment in the axial plane are considered as two of the most important issues in knee surgery such as total knee arthroplasty and high tibial osteotomy
We evaluated the posterior tibial slope (TS) and lower extremity alignment of 64 outpatients
The medial angle formed by the mechanical axes of the femur and tibia was the tibiofemoral (TF) angle, which measured the overall alignment of the lower limb

Summary

Introduction

Restoration of the neutral mechanical alignment of the lower limb in the coronal plane and the correct rotational alignment in the axial plane are considered as two of the most important issues in knee surgery such as total knee arthroplasty and high tibial osteotomy. The importance of restoring the alignment of the lower extremity after total knee arthroplasty has been emphasized [1], while radiographic variation in the normal lower extremity alignments of different population subsets has been reported [2] [3]. A total knee replacement with varus alignment has been shown to fail substantially earlier than those with neutral or valgus alignment (Ritter). The normal alignment of the lower extremity has not been documented clearly in Turkish adults. We evaluated the posterior tibial slope (TS) and lower extremity alignment of 64 outpatients

Objectives

Methods

Results

Conclusion