Relationship of native tibial plateau anatomy with stability testing in the anterior cruciate ligament-deficient knee

Knee Surg Sports Traumatol Arthrosc. 2012 Nov;20(11):2220-4. doi: 10.1007/s00167-011-1854-9. Epub 2011 Dec 29.

Abstract

Purpose: Recent attention has been drawn to tibial plateau slope and depth with relation to both risk of anterior cruciate ligament (ACL) tear and kinematics in the cruciate-deficient knee. The purpose was to evaluate the relationship between native proximal tibial anatomy and knee kinematics in the anterior cruciate-deficient knee.

Methods: Twenty-two cadaveric knees underwent CT scanning to measure proximal tibia anatomy. Translation was measured during Lachman and mechanized pivot-shift tests on the intact knee and then after resection of the ACL. Pearson's correlation was calculated to assess the relationship between tibial translation of the ACL-deficient knee and tibial plateau anatomic parameters.

Results: No significant correlation was found between ACL-deficient kinematic testing and tibial slope or depth (n.s.). Lateral compartment translation on Lachman and pivot-shift testing correlated with lateral compartment AP length (P = 0.007 and P = 0.033, respectively). The ratio of lateral AP length to medial AP length correlated with lateral compartment translation during the pivot shift (P = 0.002).

Conclusion: There was a poor correlation between native tibial slope and kinematic testing. There were, however, increases in translation during pivot-shift and Lachman testing with increased AP length of the lateral compartment. In addition, the finding of increased pivot-shift magnitude when the lateral compartment was relatively wide in the AP plane compared to the medial compartment suggests that patients with a "dominant" lateral compartment may be prone to a greater magnitude of instability after ACL injury.

MeSH terms

  • Anterior Cruciate Ligament Injuries*
  • Biomechanical Phenomena
  • Cadaver
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Knee Joint / diagnostic imaging
  • Knee Joint / physiology*
  • Male
  • Middle Aged
  • Movement / physiology*
  • Tibia / anatomy & histology*
  • Tibia / diagnostic imaging
  • Tibia / physiology*
  • Tomography, X-Ray Computed