Posterior Tibial Slope in Anterior Cruciate Ligament Surgery: A Systematic Review
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Authors
Mandalia, V.
Bayley, M.
Bhamber, N.
Middleton, S.
Houston, J.
Issue Date
2023-09-01
Type
Journal Article
Language
eng
Keywords
Acl , Knee , Ligament , Tibia
Alternative Title
BACKGROUND: While the literature suggests a correlation between posterior tibial slope and sagittal stability of the knee, there is a lack of consensus relating to how to measure the slope, what a normal slope value would be, and which critical values should guide extra surgical treatment. We performed a systematic literature review looking at the posterior tibial slope and cruciate ligament surgery. Our aims were to define a gold standard measurement technique of posterior tibial slope, as well as determining its normal range and the important values for consideration of adjuncts during cruciate ligament surgery. METHODS: Electronic searches of MEDLINE (PubMed), CINAHL, Cochrane, Embase, ScienceDirect, and NICE in June 2020 were completed. Inclusion criteria were original studies in peer-reviewed English language journals. A quality assessment of included studies was completed using the Methodological Index for Non-Randomized Studies (MINORS) Criteria. RESULTS: Two-hundred and twenty-one papers were identified; following exclusions 34 papers were included for data collection. The mean MINORS score was 13.8 for non-comparative studies and 20.4 for comparative studies, both indicating fair to good quality studies. A large variation in the posterior tibial slope measurement technique was identified, resulting in a wide range of values reported. A significant variation in slope value also existed between different races, ages and genders. CONCLUSION: Cautiously, the authors suggest a normal range of 6-12º, using the proximal tibial axis at 5 and 15 cms below the joint. We suggest 12º as a cut-off value for slope-reducing osteotomy as an adjunct to revision ligament reconstruction.
Description
Citation
Mandalia V, Bayley M, Bhamber N, Middleton S, Houston J. Posterior Tibial Slope in Anterior Cruciate Ligament Surgery: A Systematic Review. Indian J Orthop. 2023;57(9):1376-86.
Publisher
Wolters Kluwer
License
© Indian Orthopaedics Association 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
Journal
Indian journal of orthopaedics