Naendrup Jan-Hendrik, Drouven Sabrina F, Shaikh Humza S, Jaecker Vera, Offerhaus Christoph, Shafizadeh Sven T, Pfeiffer Thomas R
Department of Trauma and Orthopaedic Surgery, Witten/Herdecke University, Cologne Merheim Medical Centre, Köln, Germany; Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; University Hospital Cologne, University of Cologne, Köln, Germany.
Department of Trauma and Orthopaedic Surgery, Witten/Herdecke University, Cologne Merheim Medical Centre, Köln, Germany.
Knee. 2020 Jun;27(3):923-929. doi: 10.1016/j.knee.2020.01.013. Epub 2020 Feb 12.
Tibial slope measurements are important in guiding clinical decisions in the field of orthopedic surgery. However, there are multiple techniques across different medical imaging modalities and little is known about its impact on result and validity of the measurement. Therefore, the purpose of this study was to compare tibial slope measurements from lateral radiographs, magnetic resonance imaging (MRI) and computed tomography (CT) scans in order to better assess the clinical significance of measured tibial slope values.
Twenty patients with complete medical imaging (lateral radiographs, MRI, CT scans) undergoing anterior cruciate ligament revision surgery were included. The tibial slope of the medial and lateral plateau were measured and compared using the methods of Dejour et al. and Utzschneider et al. on lateral radiographs, by Hudek et al. and Hashemi et al. on MRI and CT scans, and by Zhang et al. on three-dimensional reconstructions of CT scans.
Mean differences up to 5.4 ± 2.8° (P < 0.05) and 4.9 ± 2.6° (P < 0.05) between different measurement methods were found for the medial and lateral tibial slope, respectively. Depending on how the tibial shaft axis was defined, significant differences between the respective measurement methods and a relevant degree of variability were identified. Pearson correlation coefficients between the measurement methods varied distinctly from moderate to strong correlations.
Tibial slope measurements have a high degree of variability and inaccuracy between imaging modalities and different measurement methods. Care must be taken when deciding on indications based on individual modality measurements.
胫骨坡度测量对于指导骨科手术领域的临床决策至关重要。然而，不同医学成像模态有多种测量技术，而对于其对测量结果和有效性的影响却知之甚少。因此，本研究的目的是比较从侧位X线片、磁共振成像（MRI）和计算机断层扫描（CT）扫描获得的胫骨坡度测量值，以便更好地评估所测胫骨坡度值的临床意义。
纳入20例接受前交叉韧带翻修手术且有完整医学成像（侧位X线片、MRI、CT扫描）的患者。使用Dejour等人和Utzschneider等人的方法在侧位X线片上测量并比较内侧和外侧平台的胫骨坡度，使用Hudek等人和Hashemi等人的方法在MRI和CT扫描上测量并比较，以及使用Zhang等人的方法在CT扫描的三维重建上测量并比较。
在内侧和外侧胫骨坡度方面，不同测量方法之间的平均差异分别高达5.4±2.8°（P<0.05）和4.9±2.6°（P<0.05）。根据胫骨骨干轴线的定义方式，各测量方法之间存在显著差异以及相当程度的变异性。测量方法之间的Pearson相关系数从中度到强相关有明显变化。
不同成像模态和不同测量方法之间的胫骨坡度测量具有高度变异性和不准确性。基于个体模态测量来决定手术适应症时必须谨慎。
