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. 2023 Dec;51(14):3706-3713.
doi: 10.1177/03635465231204362. Epub 2023 Nov 4.

Comparison of Size of Posterior Tibial Slope and Medial Tibial Depth in Patients With an Isolated Meniscal Tear Requiring Surgery and Matched Uninjured Controls

Samuel C Barnett  1 , Gabriella Portila  1   2 , Ryan Sanborn  1 , Gabrielle S Perone  1   3 , Alex Emami  1 , Ata M Kiapour  1
Affiliations

Comparison of Size of Posterior Tibial Slope and Medial Tibial Depth in Patients With an Isolated Meniscal Tear Requiring Surgery and Matched Uninjured Controls

Samuel C Barnett et al. Am J Sports Med. 2023 Dec.

Abstract

Background: Meniscal injuries are extremely common. Several anatomic features of the knee, including the tibial plateau morphology, have been shown to influence knee biomechanics and the risk of ligamentous injuries. Little is known, however, how these morphological features influence the risk of isolated meniscal injuries in the anterior cruciate ligament (ACL)-intact knee.

Hypothesis: There are differences in the slopes and concavity of the tibial plateau between patients with isolated meniscal tears and matched uninjured controls.

Study design: Cohort study; Level of evidence, 3.

Methods: In total, 89 patients with first-instance isolated medial (n = 37) or lateral (n = 52) meniscal injuries requiring surgical treatment (mean age, 16 ± 1 years; 35% female) were matched to 89 controls with uninjured knees and no previous injuries (mean age, 16 ± 2 years; 35% female) based on age and sex. Magnetic resonance imaging scans (preoperative for injured group) were used to measure the coronal slope of the tibial plateau, posterior slope of the medial and lateral tibial plateaus, and maximum depth of the medial tibial plateau. General linear models were used to evaluate the differences in tibial plateau morphology between the knees with and without meniscal injuries, with and without adjustment for age and sex.

Results: Compared with matched controls, patients with surgically treated isolated meniscal tears had a smaller lateral tibial slope (by 2.2° [medial meniscal injury] and 1.6° [lateral meniscal injury]; P < .02), a smaller medial tibial slope (by 2.3° [medial meniscal injury] and 2.4° [lateral meniscal injury]; P < .001) and a larger medial tibial depth (by 0.8 mm [medial meniscal injury] and 0.9 mm [lateral meniscal injury]; P < .001). There were no differences in coronal tibial slope between the injured and uninjured groups. There were no differences in quantified anatomic features between the isolated medial and lateral meniscal injury groups. The same trends were observed after adjusting for age and sex.

Conclusion: This study suggests that patients with an isolated meniscal tear requiring surgery have a smaller posterior tibial slope and a larger medial tibial depth (more concave medial tibial plateau) than matched uninjured controls. This is contrary to what is known for ACL tears, in which a steeper posterior tibial slope and a shallower medial tibial depth have been associated with an increased risk of ACL tear.

Keywords: anatomy; injury; knee; meniscus; tibial plateau; tibial slope.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: This study received funding support from the Children's Hospital Orthopedic Surgery Foundation and Boston Children's Hospital Faculty Council. A.M.K. is a paid consultant for Miach Orthopaedics Inc and maintained a conflict-of-interest management plan that was approved by Boston Children's Hospital and Harvard Medical School during the conduct of the trial, with oversight by both conflict-of-interest committees and the institutional review board of Boston Children's Hospital. G.S.P. has received support for education from Kairos Surgical. A.E. has received support for education from Arthrex and CGG Medical. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

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