Medial Tibial Plateau Depth Research Articles

Risk factors for anterior cruciate ligament injury: assessment of tibial plateau anatomic variables on conventional MRI using a new combined method

The purpose of this study was to assess, in anterior cruciate ligament (ACL)-injured and -uninjured population, tibial plateau anatomic variables [medial and lateral tibial plateau slopes (MTPS and LTPS) and medial tibial plateau depth (MTPD)] on conventional magnetic resonance imaging (MRI) using a novel combined method and to determine whether these variables are risk factors for ACL injury. Seventy-three isolated ACL-injury patients (20 women and 53 men) were compared with 51 control group patients (19 women and 32 men). The combined method had very high interrater and intrarater reliability compared with previously described methods. LTPS was significantly steeper in the overall injured group and injured men compared with the control group, with odds ratio (OR) of 3.031 and 5.89, respectively. Women with ACL injury had significantly shallower MTPD than uninjured women, with OR of 4.13. We conclude that the new combined method is accurate and reproducible for assessing the tibial plateau anatomy. Women with shallower MTPD and men with steeper LTPS are at higher risk of sustaining ACL injury. Overall, steeper LTPS is a significant risk factor for sustaining ACL injury.

Shallow Medial Tibial Plateau and Steep Medial and Lateral Tibial Slopes: New Risk Factors for Anterior Cruciate Ligament Injuries

Background The geometry of the tibial plateau has been largely ignored as a source of possible risk factors for anterior cruciate ligament injury. Discovering the anterior cruciate ligament injury risk factors associated with the tibial plateau may lead to delineation of the existing sex-based disparity in anterior cruciate ligament injuries and help develop strategies for the prevention of anterior cruciate ligament injuries regardless of gender. Hypothesis Individuals with a shallower medial tibial depth of concavity, while having increased posteriorly directed slope of their tibial plateau, are at increased risk of suffering an anterior cruciate ligament injury compared with those with decreased posterior slope and increased medial tibial depth. Furthermore, these relationships are different between men and women. Study Design Case-control study (prevalence); Level of evidence, 3. Methods The medial, lateral, and coronal tibial plateau slopes as well as the medial tibial depth of concavity in 55 uninjured controls (33 women and 22 men) and 49 anterior cruciate ligament—injured cases (27 women and 22 men) were measured using magnetic resonance images. First, a preliminary t test was performed to establish any existing differences between groups. Next, a logistic regression model was developed to determine the probability of anterior cruciate ligament injury in an individual based on the measured covariates. Results The female anterior cruciate ligament—injured cases had increased lateral tibial slope (P = .03) and shallower medial tibial depth (P = .0003) compared with the uninjured controls, while male cases had increased lateral and medial tibial slope (P = .02) and shallower medial tibial depth (P = .0004) compared with controls. The logistic regression analysis and odds ratio estimates showed that medial tibial depth is an important risk factor (odds ratio = 3.03 per 1 mm decrease in its value), followed by lateral tibial slope (odds ratio = 1.17 per 1° increase in its value) in all participants. The medial tibial slope (odds ratio = 1.18 per 1° increase in its value) was a risk factor only in men. Conclusion A combination of increased posterior-directed tibial plateau slope and shallow medial tibial plateau depth could be a major risk factor in anterior cruciate ligament injury susceptibility regardless of gender. Different injury risk models may be needed for men and women as other key risk factors are identified.

The Geometry of the Tibial Plateau and Its Influence on the Biomechanics of the Tibiofemoral Joint

The geometry of the tibial plateau is complex and asymmetric. Previous research has characterized subject-to-subject differences in the tibial plateau geometry in the sagittal plane on the basis of a single parameter, the posterior slope. We hypothesized that (1) there are large subject-to-subject variations in terms of slopes, the depth of concavity of the medial plateau, and the extent of convexity of the lateral plateau; (2) medial tibial slope and lateral tibial slope are different within subjects; (3) there are sex-based differences in the slopes as well as concavities and convexities of the tibial plateau; and (4) age is not associated with any of the measured parameters. The medial, lateral, and coronal slopes and the depth of the osseous portion of the tibial plateau were measured with use of sagittal and coronal magnetic resonance images that were made for thirty-three female and twenty-two male subjects, and differences between the sexes with respect to these four parameters were assessed. Within-subject differences between the medial and lateral tibial slopes also were assessed. Correlation tests were performed to examine the existence of a linear relationship between various slopes as well as between slopes and subject age. The range of subject-to-subject variations in the tibial slopes was substantive for males and females. However, the mean medial and lateral tibial slopes in female subjects were greater than those in male subjects (p < 0.05). In contrast, the mean coronal tibial slope in female subjects was less than that in male subjects (p < 0.05). The correlation between medial and lateral tibial slopes was poor. The within-subject difference between medial and lateral tibial slopes was significant (p < 0.05). No difference in medial tibial plateau depth was found between the sexes. The subchondral bone on the lateral part of the tibia, within the articulation region, was mostly flat. Age was not associated with the observed results. The geometry of the osseous portion of the tibial plateau is more robustly explained by three slopes and the depth of the medial tibial condyle.