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Anterior metaphyseal angle; much less individual variation in determining the posterior slope of the tibia
Journal of Orthopaedic Science ( IF 1.7 ) Pub Date : 2022-07-19 , DOI: 10.1016/j.jos.2022.06.017
Sefa Akti 1 , Serdar Akti 2 , Hakan Zeybek 3 , Nilgun Ozgul Celebi 4 , Dogac Karaguven 5 , Deniz Cankaya 6
Affiliation  

Background

The question of how to specify the posterior tilt of the tibia during arthroplasty operations remains unclear. The most current opinion is that a design whereby incisions are made in parallel with the individual pre-arthritic posterior tilt will yield better post-operational results. However, the wide range of inter-individual variations of posterior tilt of the tibia and the difficult task of identifying the shaft axis of the tibia through standard lateral radiographs are the main obstacles to this particular method. Therefore, there is a need for another reference line that can be measured with plain radiography and yields less inter-individual variation. The hypothesis of this study was that the angle formed between the anterior metaphyseal line of the proximal tibia and the tibial plateau would prove to be less variable across individuals.

Methods

Long-shot radiographs of non-rotating lateral tibias of 85 patients aged between 18 and 38 years were analysed. The angle forming between the anterior metaphyseal line of the proximal tibia and the slope of the tibial plateau, and the posterior slope angle was measured by 2 separate observers using the classical method.

Results

From the measurements of the posterior slope angle taken with the classical method, 38% (33/85) of the patients were within the ±2-degree range of the mean, and the anterior metaphyseal angle was within ±2 degrees of the mean in 75% (64/85) of the total patients. 44.23% variation (CoV) in posterior slop degrees, 2.73% (CoV) variation in the anterior metaphyseal angle measured by the same researchers. The difference between the percentages of variation was also found to be statistically significant. (z = 15.36, p = 0.000).

Conclusion

The anterior metaphyseal angle can be utilized to predict the individual posterior slope. Nevertheless, further large-scale, multicentre studies are needed to establish a mean value for the population.



中文翻译:

前干骺端角;确定胫骨后斜率的个体差异要小得多

背景

在关节置换术中如何确定胫骨后倾的问题仍不清楚。目前的最新观点是,与个体关节炎前后倾平行进行切口的设计将产生更好的术后效果。然而,胫骨后倾的个体间差异很大,并且通过标准侧位X线照片识别胫骨轴的困难任务是这种特定方法的主要障碍。因此,需要另一条参考线,该参考线可以通过普通放射线照相术进行测量并且产生较小的个体间差异。这项研究的假设是,近端胫骨的前干骺端线和胫骨平台之间形成的角度在个体之间变化较小。

方法

对 85 名年龄在 18 岁至 38 岁之间的患者的非旋转外侧胫骨的长镜头 X 光片进行了分析。近端胫骨的前干骺端线与胫骨平台的坡度之间形成的角度以及后坡角由2名独立的观察者使用经典方法测量。

结果

从经典方法测量的后斜角来看,38%(33/85)的患者在平均值的±2度范围内,前干骺端角在平均值的±2度范围内。占患者总数的 75% (64/85)。由同一研究人员测量,后倾斜度有 44.23% 的变异 (CoV),前干骺端角有 2.73% 的变异 (CoV)。还发现变异百分比之间的差异具有统计显着性。(z = 15.36,p = 0.000)。

结论

前干骺端角可用于预测个体后斜率。然而,还需要进一步的大规模、多中心研究来确定人群的平均值。

更新日期:2022-07-19
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