Assessment of the tibial slope is highly dependent on the type and accuracy of the preceding acquisition

• Published in: Archives of orthopaedic and trauma surgery 2019-12, Vol.139 (12), p.1691-1697
• Main Authors: Gwinner, Clemens, Fuchs, Michael, Sentuerk, Ufuk, Perka, Carsten F., Walter, Thula C., Schatka, Imke, Rogasch, Julian M. M.
• Format: Article
• Language: English
• Subjects: Accuracy; Adolescent; Adult; Aged; Bandwidths; Child; Clinical medicine; Female; Humans; Joint surgery; Knee; Knee Joint - anatomy & histology; Knee Joint - diagnostic imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Orthopaedic Surgery; Orthopedics; Radiography - methods; Retrospective Studies; Rotation; Surgery; Tibia - anatomy & histology; Tibia - diagnostic imaging; Trauma; Young Adult
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-019-03201-y

Background Precise measurement of the tibial slope (TS) is crucial for realignment surgery, ligament reconstruction, and arthroplasty. However, there is little consensus on the ideal assessment. It was hypothesized that the tibial slope changes according to the acquisition technique and both tibial length as well as femoral rotation serve as potential confounders. Methods 104 patients (37 women, 67 men; range 12–66 years) were retrospectively selected, of which all patients underwent a 1.5-Tesla MRI and either additional standard lateral radiographs (SLR, n  = 52) or posterior stress radiographs (PSR, n  = 52) of the index knee. Two blinded observers evaluated the medial tibial slope as the medial TS is primarily used in clinical practice. Additionally, the length of the diaphyseal axis and the extent of radiographic malrotation were measured. Results Mean TS on MRI was significantly lower compared to radiographs (4.2° ± 2.9° vs. 9.1° ± 3.6°; p