Progress on measurement of tibial posterior slope and its biomechanical relationship with posterior cruciate ligament.
10.12200/j.issn.1003-0034.2022.09.019
- Author:
Juan XIAO
1
;
Hong-Lin PI
1
;
Zhi-Yong YU
1
;
Han-Yu WANG
1
;
Li WANG
1
Author Information
1. Xiangyang Hospital of Traditional Chinese Medicine Affiliated to Hubei University of Traditional Chinese Medicine, Xiangyang 441000, Hubei, China.
- Publication Type:Journal Article
- Keywords:
Biomechanical phenomena;
Posterior cruciate ligament;
Review;
Tibia
- MeSH:
Arthroplasty, Replacement, Knee/methods*;
Femur/surgery*;
Humans;
Knee Joint/surgery*;
Osteophyte/surgery*;
Posterior Cruciate Ligament/surgery*;
Tibia/surgery*
- From:
China Journal of Orthopaedics and Traumatology
2022;35(9):898-902
- CountryChina
- Language:Chinese
-
Abstract:
The most reliable and convenient measurement method of tibial posterior slope(TPS) and its biomechanical relationship with posterior cruciate ligament (PCL) are still controversial. For X-ray measurement, it is recommended to use full-length lateral X-ray of the lower extremity in quatrous section, which has advantage of highly repeatable and common in the daily diagnosis and treatment process, but it is only applicable to patients with tibial rotation within 15°. When the rotation exceeds 30°, it is difficult to identify the inner contour of platform and is no applicable. If it is only used for daily diagnosis and treatment evaluation, when tibial rotation angle is less than 15°, lateral knee X-ray also has a certain reference significance, but the accuracy could not meet requirements of higher clinical research. For CT measurement method, it could correct tibial rotation, but using the fitting point to measure tibial posterior slope on three-dimensional CT reconstruction is only applicable to knee joint without degeneration, more osteophyte affects the way of using fitting point to determine the plane of tibia with real tibia platform conformity degree, have some limitations. For measurement of MRI, it could not only correct tibial rotation, but also minimize the effect of osteophytes by using tibial anatomical axis as the reference axis, which is a good measurement method. For the biomechanical relationship between tibial posterior slope and tibial posterior slope, increased tibial posterior slope indirectly alleviates tension of PCL through tibial anterior displacement or directly reduces load on posterior cruciate ligament in tibial osteotomies, suggesting a protective mechanism for tibial posterior slope;in total knee arthroplasty with cruciate ligament preserved, the size of tibial posterior slope will affect roll back mechanism of femur. When affected knee with PCL injury, it should be avoid to release then aggravate injury, and the stress could be alleviated by increasing tibial posterior slope appropriately. There has been no unified conclusion on the range of tibial posterior slope that is most beneficial to PCL. The natural tibial posterior slope is between 7 ° and 10°, which is considered to be the most beneficial to protection of PCL, but further studies are needed according to the differences in patients' bone status, surgical methods and so on.
