The Relationship Between Posterior Tibial Slope and Pediatric Tibial Eminence Fractures
Background: Tibial eminence fractures are bony avulsions of the anterior cruciate ligament from its insertion on the intercondylar eminence. Numerous anatomic factors have been associated with anterior cruciate ligament injuries, such as posterior tibial slope, but there are few studies evaluating t...
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| Veröffentlicht in: | The American journal of sports medicine 2023-01, Vol.51 (1), p.32-37 |
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| creator | Messner, Mitchell K. McGee, Andrew S. Elphingstone, Joseph W. Schartung, David F. Frazier, Mason B. Schick, Samuel Brabston, Eugene W. Momaya, Amit M. |
| description | Background:
Tibial eminence fractures are bony avulsions of the anterior cruciate ligament from its insertion on the intercondylar eminence. Numerous anatomic factors have been associated with anterior cruciate ligament injuries, such as posterior tibial slope, but there are few studies evaluating the association with tibial eminence fracture.
Purpose:
To compare posterior tibial slope of pediatric patients with and without tibial eminence fractures. We hypothesized that a steeper posterior tibial slope would be associated with tibial eminence fracture.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
Patients who underwent surgical treatment of tibial eminence fracture were retrospectively identified between January 2000 and July 2021. Adults aged >20 years and those without adequate imaging were excluded. Controls without gross ligamentous or osseous pathology were identified. Descriptive information and Meyers and McKeever classification were recorded. Posterior tibial slope measurements were obtained by 2 independent orthopaedic surgeons twice, with measurements separated by 3 weeks. Chi-square tests and independent-samples t tests were used to compare posterior tibial slope and patient characteristics. Inter- and intrareviewer variability was determined via the intraclass correlation coefficient.
Results:
A total of 51 patients with tibial eminence fractures and 57 controls were included. By sex, tibial eminence fractures occurred among 34 male and 17 female patients with a mean age of 10.9 years. The posterior tibial slope among those with tibial eminence fractures (9.7°) was not significantly greater than that of controls (8.8°; P = .07). Male patients with a tibial eminence fracture had significantly steeper slopes compared with controls (10.0° vs 8.4°; P = .006); this difference was not observed between female patients and female controls. Patients with a slope ≥1 SD above the mean (12.0°) had 3.8 times greater odds (95% CI, 1.3-11.6; P = .017) of having a tibial eminence fracture. Male patients with a posterior tibial slope >12° had 5.8 times greater odds (95% CI, 1.1-29.1; P = .034) of having a tibial eminence fracture compared with male controls.
Conclusion:
Male patients undergoing surgical fixation of a tibial eminence fracture had an increased posterior tibial slope as compared with case-controls. Increased posterior tibial slope may be a risk factor for sustaining a tibial eminence fracture, although the clinical significance of t |
| doi_str_mv | 10.1177/03635465221137888 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2744670756</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_03635465221137888</sage_id><sourcerecordid>2744670756</sourcerecordid><originalsourceid>FETCH-LOGICAL-c368t-3538c038434d2aff3763e2d9ff8b6b6536c4fda596b7f25c2d3f6b20324a086d3</originalsourceid><addsrcrecordid>eNp1kE1LxDAQhoMoun78AC9S8OKlmmTy5VEXv0Bw0RWPJU0nGum2a9Ii_nu77KqgeJrDPO87w0PIPqPHjGl9QkGBFEpyzhhoY8waGTEpeQ6g5DoZLfb5Atgi2ym9UkqZVmaTbIESEjTXI_I0fcHsHmvbhbZJL2GenWP3jthkkzZ1GEMbs2kog62zh7qdY2abKptgFWwXg_taXcxCg43D7DJa1_UR0y7Z8LZOuLeaO-Tx8mI6vs5v765uxme3uQNluhwkGEfBCBAVt96DVoC8OvXelKpUEpQTvrLyVJXac-l4BV6VnAIXlhpVwQ45WvbOY_vWY-qKWUgO69o22Pap4FoIpamWakAPf6GvbR-b4buBUpQOagQfKLakXGxTiuiLeQwzGz8KRouF9eKP9SFzsGruyxlW34kvzQNwvASSfcafs_83fgLAOIh6</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2760076842</pqid></control><display><type>article</type><title>The Relationship Between Posterior Tibial Slope and Pediatric Tibial Eminence Fractures</title><source>Access via SAGE</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Messner, Mitchell K. ; McGee, Andrew S. ; Elphingstone, Joseph W. ; Schartung, David F. ; Frazier, Mason B. ; Schick, Samuel ; Brabston, Eugene W. ; Momaya, Amit M.</creator><creatorcontrib>Messner, Mitchell K. ; McGee, Andrew S. ; Elphingstone, Joseph W. ; Schartung, David F. ; Frazier, Mason B. ; Schick, Samuel ; Brabston, Eugene W. ; Momaya, Amit M.</creatorcontrib><description>Background:
Tibial eminence fractures are bony avulsions of the anterior cruciate ligament from its insertion on the intercondylar eminence. Numerous anatomic factors have been associated with anterior cruciate ligament injuries, such as posterior tibial slope, but there are few studies evaluating the association with tibial eminence fracture.
Purpose:
To compare posterior tibial slope of pediatric patients with and without tibial eminence fractures. We hypothesized that a steeper posterior tibial slope would be associated with tibial eminence fracture.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
Patients who underwent surgical treatment of tibial eminence fracture were retrospectively identified between January 2000 and July 2021. Adults aged >20 years and those without adequate imaging were excluded. Controls without gross ligamentous or osseous pathology were identified. Descriptive information and Meyers and McKeever classification were recorded. Posterior tibial slope measurements were obtained by 2 independent orthopaedic surgeons twice, with measurements separated by 3 weeks. Chi-square tests and independent-samples t tests were used to compare posterior tibial slope and patient characteristics. Inter- and intrareviewer variability was determined via the intraclass correlation coefficient.
Results:
A total of 51 patients with tibial eminence fractures and 57 controls were included. By sex, tibial eminence fractures occurred among 34 male and 17 female patients with a mean age of 10.9 years. The posterior tibial slope among those with tibial eminence fractures (9.7°) was not significantly greater than that of controls (8.8°; P = .07). Male patients with a tibial eminence fracture had significantly steeper slopes compared with controls (10.0° vs 8.4°; P = .006); this difference was not observed between female patients and female controls. Patients with a slope ≥1 SD above the mean (12.0°) had 3.8 times greater odds (95% CI, 1.3-11.6; P = .017) of having a tibial eminence fracture. Male patients with a posterior tibial slope >12° had 5.8 times greater odds (95% CI, 1.1-29.1; P = .034) of having a tibial eminence fracture compared with male controls.
Conclusion:
Male patients undergoing surgical fixation of a tibial eminence fracture had an increased posterior tibial slope as compared with case-controls. Increased posterior tibial slope may be a risk factor for sustaining a tibial eminence fracture, although the clinical significance of this deserves further investigation.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/03635465221137888</identifier><identifier>PMID: 36453727</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Anterior Cruciate Ligament - surgery ; Anterior Cruciate Ligament Injuries - surgery ; Child ; Cohort Studies ; Female ; Humans ; Knee ; Knee Fractures ; Male ; Pediatrics ; Retrospective Studies ; Sports medicine ; Tibia - surgery ; Tibial Fractures - diagnostic imaging ; Tibial Fractures - surgery</subject><ispartof>The American journal of sports medicine, 2023-01, Vol.51 (1), p.32-37</ispartof><rights>2022 The Author(s)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c368t-3538c038434d2aff3763e2d9ff8b6b6536c4fda596b7f25c2d3f6b20324a086d3</citedby><cites>FETCH-LOGICAL-c368t-3538c038434d2aff3763e2d9ff8b6b6536c4fda596b7f25c2d3f6b20324a086d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/03635465221137888$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/03635465221137888$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36453727$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Messner, Mitchell K.</creatorcontrib><creatorcontrib>McGee, Andrew S.</creatorcontrib><creatorcontrib>Elphingstone, Joseph W.</creatorcontrib><creatorcontrib>Schartung, David F.</creatorcontrib><creatorcontrib>Frazier, Mason B.</creatorcontrib><creatorcontrib>Schick, Samuel</creatorcontrib><creatorcontrib>Brabston, Eugene W.</creatorcontrib><creatorcontrib>Momaya, Amit M.</creatorcontrib><title>The Relationship Between Posterior Tibial Slope and Pediatric Tibial Eminence Fractures</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
Tibial eminence fractures are bony avulsions of the anterior cruciate ligament from its insertion on the intercondylar eminence. Numerous anatomic factors have been associated with anterior cruciate ligament injuries, such as posterior tibial slope, but there are few studies evaluating the association with tibial eminence fracture.
Purpose:
To compare posterior tibial slope of pediatric patients with and without tibial eminence fractures. We hypothesized that a steeper posterior tibial slope would be associated with tibial eminence fracture.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
Patients who underwent surgical treatment of tibial eminence fracture were retrospectively identified between January 2000 and July 2021. Adults aged >20 years and those without adequate imaging were excluded. Controls without gross ligamentous or osseous pathology were identified. Descriptive information and Meyers and McKeever classification were recorded. Posterior tibial slope measurements were obtained by 2 independent orthopaedic surgeons twice, with measurements separated by 3 weeks. Chi-square tests and independent-samples t tests were used to compare posterior tibial slope and patient characteristics. Inter- and intrareviewer variability was determined via the intraclass correlation coefficient.
Results:
A total of 51 patients with tibial eminence fractures and 57 controls were included. By sex, tibial eminence fractures occurred among 34 male and 17 female patients with a mean age of 10.9 years. The posterior tibial slope among those with tibial eminence fractures (9.7°) was not significantly greater than that of controls (8.8°; P = .07). Male patients with a tibial eminence fracture had significantly steeper slopes compared with controls (10.0° vs 8.4°; P = .006); this difference was not observed between female patients and female controls. Patients with a slope ≥1 SD above the mean (12.0°) had 3.8 times greater odds (95% CI, 1.3-11.6; P = .017) of having a tibial eminence fracture. Male patients with a posterior tibial slope >12° had 5.8 times greater odds (95% CI, 1.1-29.1; P = .034) of having a tibial eminence fracture compared with male controls.
Conclusion:
Male patients undergoing surgical fixation of a tibial eminence fracture had an increased posterior tibial slope as compared with case-controls. Increased posterior tibial slope may be a risk factor for sustaining a tibial eminence fracture, although the clinical significance of this deserves further investigation.</description><subject>Adult</subject><subject>Anterior Cruciate Ligament - surgery</subject><subject>Anterior Cruciate Ligament Injuries - surgery</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Fractures</subject><subject>Male</subject><subject>Pediatrics</subject><subject>Retrospective Studies</subject><subject>Sports medicine</subject><subject>Tibia - surgery</subject><subject>Tibial Fractures - diagnostic imaging</subject><subject>Tibial Fractures - surgery</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1LxDAQhoMoun78AC9S8OKlmmTy5VEXv0Bw0RWPJU0nGum2a9Ii_nu77KqgeJrDPO87w0PIPqPHjGl9QkGBFEpyzhhoY8waGTEpeQ6g5DoZLfb5Atgi2ym9UkqZVmaTbIESEjTXI_I0fcHsHmvbhbZJL2GenWP3jthkkzZ1GEMbs2kog62zh7qdY2abKptgFWwXg_taXcxCg43D7DJa1_UR0y7Z8LZOuLeaO-Tx8mI6vs5v765uxme3uQNluhwkGEfBCBAVt96DVoC8OvXelKpUEpQTvrLyVJXac-l4BV6VnAIXlhpVwQ45WvbOY_vWY-qKWUgO69o22Pap4FoIpamWakAPf6GvbR-b4buBUpQOagQfKLakXGxTiuiLeQwzGz8KRouF9eKP9SFzsGruyxlW34kvzQNwvASSfcafs_83fgLAOIh6</recordid><startdate>202301</startdate><enddate>202301</enddate><creator>Messner, Mitchell K.</creator><creator>McGee, Andrew S.</creator><creator>Elphingstone, Joseph W.</creator><creator>Schartung, David F.</creator><creator>Frazier, Mason B.</creator><creator>Schick, Samuel</creator><creator>Brabston, Eugene W.</creator><creator>Momaya, Amit M.</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>202301</creationdate><title>The Relationship Between Posterior Tibial Slope and Pediatric Tibial Eminence Fractures</title><author>Messner, Mitchell K. ; McGee, Andrew S. ; Elphingstone, Joseph W. ; Schartung, David F. ; Frazier, Mason B. ; Schick, Samuel ; Brabston, Eugene W. ; Momaya, Amit M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c368t-3538c038434d2aff3763e2d9ff8b6b6536c4fda596b7f25c2d3f6b20324a086d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Anterior Cruciate Ligament - surgery</topic><topic>Anterior Cruciate Ligament Injuries - surgery</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Fractures</topic><topic>Male</topic><topic>Pediatrics</topic><topic>Retrospective Studies</topic><topic>Sports medicine</topic><topic>Tibia - surgery</topic><topic>Tibial Fractures - diagnostic imaging</topic><topic>Tibial Fractures - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Messner, Mitchell K.</creatorcontrib><creatorcontrib>McGee, Andrew S.</creatorcontrib><creatorcontrib>Elphingstone, Joseph W.</creatorcontrib><creatorcontrib>Schartung, David F.</creatorcontrib><creatorcontrib>Frazier, Mason B.</creatorcontrib><creatorcontrib>Schick, Samuel</creatorcontrib><creatorcontrib>Brabston, Eugene W.</creatorcontrib><creatorcontrib>Momaya, Amit M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Messner, Mitchell K.</au><au>McGee, Andrew S.</au><au>Elphingstone, Joseph W.</au><au>Schartung, David F.</au><au>Frazier, Mason B.</au><au>Schick, Samuel</au><au>Brabston, Eugene W.</au><au>Momaya, Amit M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Relationship Between Posterior Tibial Slope and Pediatric Tibial Eminence Fractures</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2023-01</date><risdate>2023</risdate><volume>51</volume><issue>1</issue><spage>32</spage><epage>37</epage><pages>32-37</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><abstract>Background:
Tibial eminence fractures are bony avulsions of the anterior cruciate ligament from its insertion on the intercondylar eminence. Numerous anatomic factors have been associated with anterior cruciate ligament injuries, such as posterior tibial slope, but there are few studies evaluating the association with tibial eminence fracture.
Purpose:
To compare posterior tibial slope of pediatric patients with and without tibial eminence fractures. We hypothesized that a steeper posterior tibial slope would be associated with tibial eminence fracture.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
Patients who underwent surgical treatment of tibial eminence fracture were retrospectively identified between January 2000 and July 2021. Adults aged >20 years and those without adequate imaging were excluded. Controls without gross ligamentous or osseous pathology were identified. Descriptive information and Meyers and McKeever classification were recorded. Posterior tibial slope measurements were obtained by 2 independent orthopaedic surgeons twice, with measurements separated by 3 weeks. Chi-square tests and independent-samples t tests were used to compare posterior tibial slope and patient characteristics. Inter- and intrareviewer variability was determined via the intraclass correlation coefficient.
Results:
A total of 51 patients with tibial eminence fractures and 57 controls were included. By sex, tibial eminence fractures occurred among 34 male and 17 female patients with a mean age of 10.9 years. The posterior tibial slope among those with tibial eminence fractures (9.7°) was not significantly greater than that of controls (8.8°; P = .07). Male patients with a tibial eminence fracture had significantly steeper slopes compared with controls (10.0° vs 8.4°; P = .006); this difference was not observed between female patients and female controls. Patients with a slope ≥1 SD above the mean (12.0°) had 3.8 times greater odds (95% CI, 1.3-11.6; P = .017) of having a tibial eminence fracture. Male patients with a posterior tibial slope >12° had 5.8 times greater odds (95% CI, 1.1-29.1; P = .034) of having a tibial eminence fracture compared with male controls.
Conclusion:
Male patients undergoing surgical fixation of a tibial eminence fracture had an increased posterior tibial slope as compared with case-controls. Increased posterior tibial slope may be a risk factor for sustaining a tibial eminence fracture, although the clinical significance of this deserves further investigation.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>36453727</pmid><doi>10.1177/03635465221137888</doi><tpages>6</tpages></addata></record> |
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| source | Access via SAGE; MEDLINE; Alma/SFX Local Collection |
| subjects | Adult Anterior Cruciate Ligament - surgery Anterior Cruciate Ligament Injuries - surgery Child Cohort Studies Female Humans Knee Knee Fractures Male Pediatrics Retrospective Studies Sports medicine Tibia - surgery Tibial Fractures - diagnostic imaging Tibial Fractures - surgery |
| title | The Relationship Between Posterior Tibial Slope and Pediatric Tibial Eminence Fractures |
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