Weinberg Douglas S, Williamson Drew F K, Gebhart Jeremy J, Knapik Derrick M, Voos James E
Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, Ohio, USA.
Am J Sports Med. 2017 Jan;45(1):106-113. doi: 10.1177/0363546516662449. Epub 2016 Oct 1.
Injuries to the anterior cruciate ligament (ACL) are common, and a number of knee morphological variables have been identified as risk factors for an ACL injury, including the posterior tibial slope (TS). However, limited data exist regarding innate population differences in the TS.
To (1) establish normative values for the medial and lateral posterior TS; (2) determine what differences exist between ages, sexes, and races; and (3) determine how internal or external tibial rotation (as occurs during sagittal knee motion) influences the stereotactic perception of the TS.
Cross-sectional study; Level of evidence, 3.
A total of 545 cadaveric specimens (1090 tibiae) were obtained from the Hamann-Todd osteological collection. Specimens were leveled in the coronal, sagittal, and axial planes using a digital laser. Virtual representations of each bone were created with a 3-dimensional digitizer apparatus. The TS of the medial and lateral tibial plateaus were measured using techniques adapted from previous radiographic protocols. Medial and lateral TS were then again measured on 200 tibiae that were internally and externally rotated by 10° (axially).
The mean (±SD) medial TS was 6.9° ± 3.7° posterior, which was greater than the mean lateral TS of 4.7° ± 3.6° posterior ( P < .001). Neither the medial nor lateral TS changed with age. Women had a greater mean TS compared with men on both the medial (7.5° ± 3.8° vs 6.8° ± 3.7°, respectively; P = .03) and lateral (5.2° ± 3.5° vs 4.6° ± 3.5°, respectively; P = .04) sides. Black specimens had a greater mean medial TS (8.7° ± 3.6° vs 5.8° ± 3.3°, respectively; P < .001) and lateral TS (5.9° ± 3.3° vs 3.8° ± 3.5°, respectively; P < .001) compared with white specimens. Axial rotation was shown to increase the perception of the medial and lateral TS ( P < .001).
The medial TS was shown to be greater than the lateral TS. Important sex- and race-based differences exist in the TS. This study also highlights the role of axial rotation in measuring the TS.
前交叉韧带（ACL）损伤很常见，并且一些膝关节形态学变量已被确定为ACL损伤的危险因素，包括胫骨后倾（TS）。然而，关于TS在人群中的固有差异的数据有限。
（1）建立内侧和外侧胫骨后倾的标准值；（2）确定年龄、性别和种族之间存在哪些差异；（3）确定胫骨内旋或外旋（如在膝关节矢状面运动期间发生的那样）如何影响TS的立体定向感知。
横断面研究；证据等级，3级。
从哈曼-托德骨学收藏中获取了总共545个尸体标本（1090根胫骨）。使用数字激光将标本在冠状面、矢状面和轴面上调平。使用三维数字化仪设备创建每根骨头的虚拟模型。内侧和外侧胫骨平台的TS采用先前放射学方案改编的技术进行测量。然后，再次对200根分别进行了10°内旋和外旋（轴向）的胫骨测量内侧和外侧TS。
内侧TS的平均值（±标准差）为后倾6.9°±3.7°，大于外侧TS的平均值后倾4.7°±3.6°（P <.001）。内侧和外侧TS均不随年龄变化。女性在内侧（分别为7.5°±3.8°和6.8°±3.7°；P = 0.03）和外侧（分别为5.2°±3.5°和4.6°±3.5°；P = 0.04）的平均TS均高于男性。与白色标本相比，黑色标本的内侧平均TS（分别为8.7°±3.6°和5.8°±3.3°；P <.001）和外侧平均TS（分别为5.9°±3.3°和3.8°±3.5°；P <.001）更大。轴向旋转显示会增加内侧和外侧TS的感知（P <.001）。
内侧TS大于外侧TS。TS存在基于性别和种族的重要差异。本研究还强调了轴向旋转在测量TS中的作用。
