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J Biomech. 2018 Oct 5;79:212-217. doi: 10.1016/j.jbiomech.2018.07.047. Epub 2018 Aug 9.

Automated, accurate, and three-dimensional method for calculating sagittal slope of the tibial plateau.

Author information

1
Department of Biomechanics, Hospital for Special Surgery, Weill Cornell Medicine of Cornell University, 535 E 70(th) St, New York, NY 10021, USA.
2
Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine of Cornell University, 535 E 70(th) St, New York, NY 10021, USA.
3
Department of Biomechanics, Hospital for Special Surgery, Weill Cornell Medicine of Cornell University, 535 E 70(th) St, New York, NY 10021, USA. Electronic address: imhauserc@hss.edu.

Abstract

Increased posterior-inferior directed slope of the subchondral bone of the lateral tibial plateau is a risk factor for noncontact rupture of the anterior cruciate ligament (ACL). Previous measures of lateral tibial slope, however, vary from study to study and often lack documentation of their accuracy. These factors impede identifying the magnitude of lateral tibial slope that increases risk of noncontact ACL rupture. Therefore, we developed and evaluated a new method that (1) requires minimal user input; (2) employs 3D renderings of the tibia that are referenced to a 3D anatomic coordinate system; and (3) is precise, reliable, and accurate. The user first isolated the proximal tibia from computed tomography (CT) scans. Then, the algorithm placed the proximal tibia in an automatically generated tibial coordinate system. Next, it identified points along the rim of subchondral bone around the lateral tibial plateau, iteratively fit a plane to this rim of points, and, finally, referenced the plane to the tibial coordinate system. Precision and reliability of the lateral slope measurements were respectively assessed via standard deviation and intra- and inter-class correlation coefficients using CT scans of three cadaveric tibia. Accuracy was quantified by comparing changes in lateral tibial slope calculated by our algorithm to predefined in silico changes in slope. Precision, reliability, and accuracy were ≤0.18°, ≥0.998, and ≤0.13°, respectively. We will use our novel method to better understand the relationship between lateral tibial slope and knee biomechanics towards preventing ACL rupture and improving its treatment.

KEYWORDS:

Algorithm; Anterior cruciate ligament; Lateral plateau; Noncontact; Rupture; Sagittal; Slope; Tibia

PMID:
30217556
DOI:
10.1016/j.jbiomech.2018.07.047
[Indexed for MEDLINE]

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