Top

Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

Open Access 01-03-2011 | Knee

Increased medial tibial slope in teenage pediatric population with open physes and anterior cruciate ligament injuries

Authors: Shail Vyas, Carola F. van Eck, Nina Vyas, Freddie H. Fu, Norman Y. Otsuka

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2011

Abstract

Purpose

Variations in bony morphology have been associated with anterior cruciate ligament (ACL) injury risk. The primary aim of this study was to compare the tibial slope in the teenage pediatric population with open physes, with and without ACL injury. The secondary aims were to compare the notch width index (NWI) and determine the influence of gender and age on tibial slope and NWI.

Methods

Thirty-nine teenage pediatric subjects were included in this study, 16 with and 23 without ACL injury. Medial tibial slope and lateral tibial slope and NWI as measured on plain radiographs were compared between the groups using an independent t-test. Comparison of tibial slope and NWI was also performed between male and female subjects. Pearson correlation coefficient between age and tibial slope and NWI was calculated.

Results

The medial tibial slope averaged 10.2 (±3.9) degrees, the lateral tibial slope 11.5 (±3.9) degrees, and the NWI 0.26. There was a significant difference in medial tibial slope between the ACL-injured (12.1 degrees) subjects and the controls (8.9 degrees) (P = 0.009). There was no significant difference in lateral tibial slope or NWI between the groups. There was no significant difference in the medial tibial slope and lateral tibial slope and NWI between the male and female subjects. Subject age was not correlated with medial tibial slope and lateral tibial slope or NWI.

Conclusion

There was an increased medial tibial slope in ACL-injured teenagers with open physes, when compared to a control group of teenager with open physes without ACL injury.

Anderson AF, Anderson CN, Gorman TM, Cross MB, Spindler KP (2007) Radiographic measurements of the intercondylar notch: are they accurate? Arthroscopy 23: 261–268, 268 e261–e262

Anderson AF, Lipscomb AB, Liudahl KJ, Addlestone RB (1987) Analysis of the intercondylar notch by computed tomography. Am J Sports Med 15:547–552CrossRefPubMed

Brandon ML, Haynes PT, Bonamo JR, Flynn MI, Barrett GR, Sherman MF (2006) The association between posterior-inferior tibial slope and anterior cruciate ligament insufficiency. Arthroscopy 22:894–899CrossRefPubMed

Charlton WP, St John TA, Ciccotti MG, Harrison N, Schweitzer M (2002) Differences in femoral notch anatomy between men and women: a magnetic resonance imaging study. Am J Sports Med 30:329–333PubMed

Chhabra A, Starman JS, Ferretti M, Vidal AF, Zantop T, Fu FH (2006) Anatomic, radiographic, biomechanical, and kinematic evaluation of the anterior cruciate ligament and its two functional bundles. J Bone Joint Surg Am 88(Suppl 4):2–10CrossRefPubMed

Davis TJ, Shelbourne KD, Klootwyk TE (1999) Correlation of the intercondylar notch width of the femur to the width of the anterior and posterior cruciate ligaments. Knee Surg Sports Traumatol Arthrosc 7:209–214CrossRefPubMed

Dejour H, Bonnin M (1994) Tibial translation after anterior cruciate ligament rupture. Two radiological tests compared. J Bone Joint Surg Br 76:745–749PubMed

Dienst M, Schneider G, Altmeyer K, Voelkering K, Georg T, Kramann B, Kohn D (2007) Correlation of intercondylar notch cross sections to the ACL size: a high resolution MR tomographic in vivo analysis. Arch Orthop Trauma Surg 127:253–260CrossRefPubMed

Domzalski M, Grzelak P, Gabos P (2010) Risk factors for anterior cruciate ligament injury in skeletally immature patients: analysis of intercondylar notch width using magnetic resonance imaging. Int Orthop. doi:10.1007/s00264-010-0987-7

10.

Gabriel MT, Wong EK, Woo SL, Yagi M, Debski RE (2004) Distribution of in situ forces in the anterior cruciate ligament in response to rotatory loads. J Orthop Res 22:85–89CrossRefPubMed

11.

Genin P, Weill G, Julliard R (1993) The tibial slope. Proposal for a measurement method. J Radiol 74:27–33PubMed

12.

Giffin JR, Vogrin TM, Zantop T, Woo SL, Harner CD (2004) Effects of increasing tibial slope on the biomechanics of the knee. Am J Sports Med 32:376–382CrossRefPubMed

13.

Hashemi J, Chandrashekar N, Gill B, Beynnon BD, Slauterbeck JR, Schutt RC Jr, Mansouri H, Dabezies E (2008) The geometry of the tibial plateau and its influence on the biomechanics of the tibiofemoral joint. J Bone Joint Surg Am 90:2724–2734CrossRefPubMed

14.

Hashemi J, Chandrashekar N, Mansouri H, Gill B, Slauterbeck JR, Schutt RC Jr, Dabezies E, Beynnon BD (2010) Shallow medial tibial plateau and steep medial and lateral tibial slopes: new risk factors for anterior cruciate ligament injuries. Am J Sports Med 38:54–62CrossRefPubMed

15.

Hernigou P, Garabedian JM (2002) Intercondylar notch width and the risk for anterior cruciate ligament rupture in the osteoarthritic knee: evaluation by plain radiography and CT scan. Knee 9:313–316CrossRefPubMed

16.

Herzog RJ, Silliman JF, Hutton K, Rodkey WG, Steadman JR (1994) Measurements of the intercondylar notch by plain film radiography and magnetic resonance imaging. Am J Sports Med 22:204–210CrossRefPubMed

17.

Houseworth SW, Mauro VJ, Mellon BA, Kieffer DA (1987) The intercondylar notch in acute tears of the anterior cruciate ligament: a computer graphics study. Am J Sports Med 15:221–224CrossRefPubMed

18.

Ireland ML, Ballantyne BT, Little K, McClay IS (2001) A radiographic analysis of the relationship between the size and shape of the intercondylar notch and anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc 9:200–205CrossRefPubMed

19.

LaPrade RF, Burnett QM, 2nd (1994) Femoral intercondylar notch stenosis and correlation to anterior cruciate ligament injuries. A prospective study. Am J Sports Med 22:198–202 Discussion 203CrossRefPubMed

20.

Lombardo S, Sethi PM, Starkey C (2005) Intercondylar notch stenosis is not a risk factor for anterior cruciate ligament tears in professional male basketball players: an 11-year prospective study. Am J Sports Med 33:29–34CrossRefPubMed

21.

Lund-Hanssen H, Gannon J, Engebretsen L, Holen KJ, Anda S, Vatten L (1994) Intercondylar notch width and the risk for anterior cruciate ligament rupture. A case-control study in 46 female handball players. Acta Orthop Scand 65:529–532CrossRefPubMed

22.

Murshed KA, Cicekcibasi AE, Karabacakoglu A, Seker M, Ziylan T (2005) Distal femur morphometry: a gender and bilateral comparative study using magnetic resonance imaging. Surg Radiol Anat 27:108–112CrossRefPubMed

23.

Norwood LA Jr, Cross MJ (1977) The intercondylar shelf and the anterior cruciate ligament. Am J Sports Med 5:171–176CrossRefPubMed

24.

Petersen W, Tillmann B (1999) Structure and vascularization of the cruciate ligaments of the human knee joint. Anat Embryol (Berl) 200:325–334CrossRef

25.

Simon RA, Everhart JS, Nagaraja HN, Chaudhari AM (2010) A case-control study of anterior cruciate ligament volume, tibial plateau slopes and intercondylar notch dimensions in ACL-injured knees. J Biomech. doi:S0021-9290(10)00142-9

26.

Souryal TO, Freeman TR (1993) Intercondylar notch size and anterior cruciate ligament injuries in athletes. A prospective study. Am J Sports Med 21:535–539CrossRefPubMed

27.

Souryal TO, Moore HA, Evans JP (1988) Bilaterality in anterior cruciate ligament injuries: associated intercondylar notch stenosis. Am J Sports Med 16:449–454CrossRefPubMed

28.

Stijak L, Herzog RF, Schai P (2008) Is there an influence of the tibial slope of the lateral condyle on the ACL lesion? A case-control study. Knee Surg Sports Traumatol Arthrosc 16:112–117CrossRefPubMed

29.

Stijak L, Radonjic V, Nikolic V, Blagojevic Z, Aksic M, Filipovic B (2009) Correlation between the morphometric parameters of the anterior cruciate ligament and the intercondylar width: gender and age differences. Knee Surg Sports Traumatol Arthrosc 17:812–817CrossRefPubMed

30.

Tillman MD, Smith KR, Bauer JA, Cauraugh JH, Falsetti AB, Pattishall JL (2002) Differences in three intercondylar notch geometry indices between males and females: a cadaver study. Knee 9:41–46CrossRefPubMed

31.

van Eck CF, Martins CA, Lorenz SG, Fu FH, Smolinski P (2010) Assessment of correlation between knee notch width index and the three-dimensional notch volume. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-010-1131-3. (Epub ahead of print)

32.

van Eck CF, Martins CA, Vyas SM, Celentano U, van Dijk CN, Fu FH (2010) Femoral intercondylar notch shape and dimensions in ACL-injured patients. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-010-1135-z. (Epub ahead of print)

33.

Zantop T, Petersen W, Sekiya JK, Musahl V, Fu FH (2006) Anterior cruciate ligament anatomy and function relating to anatomical reconstruction. Knee Surg Sports Traumatol Arthrosc 14:982–992CrossRefPubMed

Title: Increased medial tibial slope in teenage pediatric population with open physes and anterior cruciate ligament injuries
Authors: Shail Vyas
Carola F. van Eck
Nina Vyas
Freddie H. Fu
Norman Y. Otsuka
Publication date: 01-03-2011
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-010-1216-z

2024 ASCO Annual Meeting

Springer Medicine

Increased medial tibial slope in teenage pediatric population with open physes and anterior cruciate ligament injuries

Abstract

Purpose

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2011

Biomechanical characterization of double-bundle femoral press-fit fixation techniques

Surgery for ACL deficiency in patients over 50

Navigated intra-articular ACL reconstruction with additional extra-articular tenodesis using the same hamstring graft

The combination of radiostereometric analysis and the telos stress device results in poor precision for knee laxity measurements after anterior cruciate ligament reconstruction

Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings

Platelet concentrate vs. saline in a rat patellar tendon healing model