Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul, 06698, Republic of Korea.
Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Surg Radiol Anat. 2020 Jun;42(6):667-672. doi: 10.1007/s00276-020-02429-3. Epub 2020 Feb 21.
Posterior tibial slope (PTS) is an important parameter of sagittal alignment associated with postoperative stability and kinematics after total knee arthroplasty (TKA). However, data are limited regarding the innate gender differences in PTS in Koreans. The current study separately measured the PTS of the medial and lateral tibial plateau on magnetic resonance images of 511 patients with knee joint osteoarthritis who had Kellgren and Lawrence grade 3 and 4 (430 women, 81 men) and compared the measurements between and within the genders. The tibia was then rotated to the tibial plateau with the tibial centroid axis and the PTS was evaluated from best-fit planes on the surface of the proximal tibia and individually for the medial, lateral, and overall plateaus. The average overall PTS was 10.0° ± 3.5°. The average overall PTS of the female and male patients was 10.2° ± 3.4° and 8.8° ± 4.0°, respectively. The average medial PTS was 10.4° ± 4.0°, significantly greater than the mean lateral PTS of 8.7° ± 3.9° (P < 0.05). The average medial and lateral tibial slopes for female patients were 10.7° ± 3.8° and 8.8° ± 3.8°, respectively, while the average medial and lateral tibial slopes for male patients were 8.9° ± 4.8° and 7.9° ± 4.7°, respectively. The medial and overall PTS were significantly greater in female patients than in male patients (P < 0.05). The results showed a gender difference in PTS and that medial PTS was greater than lateral PTS. These findings have clinical relevance in knee reconstructive surgery for determining ideal placement of the posterior slope tibial component. Surgeons should be aware of variability and gender differences in the tibial slope of patients undergoing TKA.
胫骨后倾角（PTS）是与全膝关节置换术后稳定性和运动学相关的矢状面排列的重要参数。然而，关于韩国人 PTS 的固有性别差异的数据有限。本研究分别测量了 511 例膝关节骨关节炎患者膝关节磁共振成像上的内侧和外侧胫骨平台 PTS（430 名女性，81 名男性），并比较了性别间和性别内的测量值。然后，将胫骨绕胫骨中心点轴旋转到胫骨平台，根据胫骨近端表面的最佳拟合平面评估 PTS，并分别评估内侧、外侧和整体平台的 PTS。平均整体 PTS 为 10.0°±3.5°。女性和男性患者的平均整体 PTS 分别为 10.2°±3.4°和 8.8°±4.0°。平均内侧 PTS 为 10.4°±4.0°，显著大于平均外侧 PTS 的 8.7°±3.9°（P<0.05）。女性患者的平均内侧和外侧胫骨斜率分别为 10.7°±3.8°和 8.8°±3.8°，而男性患者的平均内侧和外侧胫骨斜率分别为 8.9°±4.8°和 7.9°±4.7°。女性患者的内侧和整体 PTS 明显大于男性患者（P<0.05）。结果表明 PTS 存在性别差异，且内侧 PTS 大于外侧 PTS。这些发现对膝关节重建手术中确定后倾胫骨组件的理想位置具有临床意义。外科医生应该意识到接受 TKA 的患者胫骨斜率的可变性和性别差异。
