Jan-Hendrik Naendrup1, Sabrina F Drouven2, Humza S Shaikh3, Vera Jaecker2, Christoph Offerhaus4, Sven T Shafizadeh4, Thomas R Pfeiffer5. 1. 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. 2. Department of Trauma and Orthopaedic Surgery, Witten/Herdecke University, Cologne Merheim Medical Centre, Köln, Germany. 3. Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 4. Department of Orthopaedic Surgery and Sports Traumatology, Sana Medical Centre Cologne, Köln, Germany. 5. 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. Electronic address: T.Pfeiffer@email.de.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Iskandar Tamimi; Joaquin Ballesteros; Almudena Perez Lara; Jimmy Tat; Motaz Alaqueel; Justin Schupbach; Yousef Marwan; Cristina Urdiales; Jesus Manuel Gomez-de-Gabriel; Mark Burman; Paul Andre Martineau Journal: Orthop J Sports Med Date: 2021-09-21