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Joint Diseases and
Related Surgery
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Original Article · Open access

Correlation of medial tibial slope and lateral tibial slope measured on radiographs and magnetic resonance imaging in patients with anterior cruciate ligament injury

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Keng-Yi Lin

Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan

ORCID: 0000-0003-3774-6116

Cheng-Pang Yang

Department of Orthopedic Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan City, Taiwan

ORCID: 0009-0007-8547-4561

Shang-Yu Yao

Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan

ORCID: 0009-0009-9907-3990

Yu-Chieh Hung

Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan

ORCID: 0009-0000-4880-4049

Shih-Feng Hung

Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan

ORCID: 0000-0003-1545-4817

Yi-Jou Chen

Department of Orthopedic Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan City, Taiwan

ORCID: 0009-0009-2342-7457

Chih-Hao Chiu

Department of Orthopedic Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan City, Taiwan

ORCID: 0000-0001-9415-5115

Chin-Shan Ho

National Taiwan Sport University, Graduate Institute of Sports Science, Taoyuan City, Taiwan

ORCID: 0000-0003-2441-6222

Yi-Sheng Chan

Department of Orthopedic Surgery, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan

ORCID: 0000-0001-7413-1431

Abstract

Objectives: The study aimed to investigate the correlation between medial tibial slope (MTS) and lateral tibial slope (LTS) on magnetic resonance imaging (MRI), MTS measured by different imaging, and the intra- and interobserver reliability of measurements between reviewers with gaps of experience over 10 years.

Patients and methods: This retrospective study included 97 patients (93 males, 4 females; mean age: 30.8±8.3 years; range, 17 to 49 years) with anterior cruciate ligament (ACL) injuries who subsequently underwent double-bundle ACL reconstruction by a single surgeon between January 2005 and December 2014. The MTS was measured on lateral knee radiographs, and MTS and LTS were measured on MRIs. Three different reviewers, including a postgraduate year doctor, an orthopedic resident, and an attending orthopedic surgeon, performed the measurements. Each reviewer measured the slope of the same image three times. The correlations of MTS on radiographs and MTS/LTS on MRIs were calculated. Intra- and interobserver reliability were evaluated.

Results: The average MTS and LTS measured on MRI were not significantly different (6.4° and 6.9°, respectively; p=0.268) and exhibited a moderate positive correlation (r=0.544, p<0.001). The average MTS on radiographs was significantly greater than that on MRI (10.5° and 6.4°, respectively; p<0.001) with a low positive correlation (r=0.480, p<0.001). The intraobserver reliability of the postgraduate year doctor, the orthopedic resident, and the attending orthopedic surgeon were moderate to excellent. The interobserver reliability of MTS on radiographs was excellent (intraclass correlation coefficient [ICC]=0.925; p<0.001). The interobserver reliability of MTS on MRI as well as LTS on MRI was good (ICC=0.755 and 820, respectively; all p values <0.001).

Conclusion: Average MTS and LTS measured on MRI in patients with ACL injury exhibited a moderate positive correlation. The average MTS measured on radiographs was significantly greater than that on MRI with a low positive correlation.

Declarations

Ethics Committee Approval

The study protocol was approved by the Chang Gung Medical Foundation Institutional Review Board (date: 12.09.2022, no: 202201347B0). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Informed Consent

A written informed consent was obtained from each patient.

Author Contributions

Study conception and design, data collection, performing analysis; and writing the paper: K.Y.L.; Study conception and design data, collection: C.P.Y.; Data collection: S.Y.Y., Y.C.H., S.F.H., Y,J,C.; Study conception and design: C.H.C., C.S.H., Y.S.C.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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