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J Knee Surg 2023; 36(01): 062-067
DOI: 10.1055/s-0041-1728816
Original Article

A Cadaveric Anatomical Study of the Relationship between Proximal Tibial Slope and Coronal Plane Deformity

Julia Foos
1   Division of Pediatric Orthopaedic Surgery, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio
,
Kouami Amakoutou 
1   Division of Pediatric Orthopaedic Surgery, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio
,
Daniel R. Cooperman
2   Department of Orthopaedic Surgery and Rehabilitation, Yale School of Medicine, New Haven, Connecticut
,
Raymond W. Liu
1   Division of Pediatric Orthopaedic Surgery, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio
› Author Affiliations Funding None.
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Abstract

Medial proximal tibial angle (MPTA) and posterior proximal tibial angle (PPTA) are commonly used to characterize the geometry of proximal tibia and are important considerations in lower extremity realignment procedures and total knee arthroplasty. This study utilized a large cadaveric collection to explore relationships between tibial slope and coronal plane deformity of the tibia. We utilized 462 well-preserved skeletons (924 tibiae), excluding any with fracture or obvious rheumatologic or infectious findings. Custom cards were made with different sized arcs on the bottom surface, so that they could rest on the anterior and posterior aspects of the medial and lateral tibial plateaus of each bone to measure PPTA. Previously measured MPTA values for the same bones were also utilized. Multiple regression analysis was used to determine relationship between MPTA and medial and lateral PPTAs. The mean age was 56 ± 10 years, with 13% female and 31% African American (remainder Caucasian). The mean MPTA was 87.2 ± 2.4 degrees. The mean medial plateau PPTA was 81.5 ± 3.8 degrees and mean lateral plateau PPTA was 81.3 ± 3.7 degrees. Regression analysis found that MPTA was significantly associated with both medial and lateral PPTAs (standardized betas 0.197 and 0.146, respectively, p < 0.0005 for both). There was a significant correlation between lateral and medial PPTAs (r = 0.435, p = 0.03). The clinical significance of these findings warrants further investigation and emphasizes the importance of carefully assessing the sagittal plane when planning reconstruction of a tibia with varus or valgus deformity, particularly high tibial osteotomies.

Keywords

proximal tibia - medial proximal tibial angle - posterior proximal tibial angle - coronal plane - sagittal plane

Authors' Contributions

J.F. and K.A. contributed in design and conception of the study, data collection, analysis and interpretation, writing, and reviewing manuscript. D.R.C. contributed in the analysis and interpretation, writing, and critically reviewing manuscript. R.W.L. contributed in design and conception of the study, data collection, analysis and interpretation, writing, and critically reviewing manuscript.




Publication History

Received: 04 September 2020

Accepted: 12 March 2021

Article published online:
28 April 2021

© 2021. Thieme. All rights reserved.

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