Tibial Plateau Slope as Risk Factor among Filipino Patients with Anterior Cruciate Ligament Injury: A Single Center Study

John Christopher Ragasa, MD - SLMC

Background: Anterior Cruciate Ligament injuries dominates sports-related injuries up to present time despite the massive studies provided pertaining to its associated risk factors. In our knowledge, there are no or perhaps a few published studies relating ACL injuries and tibial plateau slope in Filipino population. Of significant note is that majority of the research literatures are giving emphasis on complications of ACL injury treatment whereas this paper will provide insight on the preventive side of the injury.

Materials and methods: This study illustrates the association of tibial plateau slope with ACL injury in Filipino population. This study includes two groups of 18-45 years old Filipinos. The first group includes 89 subjects with ACL injury, with MRI of the knee, and who underwent ACL reconstruction. The second group includes 128 subjects with who had knee pain for which an MRI was done. No ACL rupture was seen on MRI and no surgery was done. The medial tibial plateau slope (MTPS), lateral tibial plateau slope (LTPS) and average tibial plateau slope (ATPS) were measured and compared for both groups to determine the association ACL injury with the tibial plateau slope.

Results: Mean age of those without ACL injury was statistically higher than those with ACL injury. Proportion of males among those with ACL was statistically higher than those without ACL injury. Mean lateral, medial, and average tibial plateau slopes were statistically higher among those with ACL injury than those without injury and for every 1-degree of each slope, the risk increases by 3%, 4% and 5%, respectively. ATPS cut-off of ≥14.00° provided minimal acceptable accuracy of predicting ACL injury and showed that the risk of ACL injury increases by 202% compared to those with an average tibial plateau slope of less than 14.00°.

Conclusion: Lateral, medial and average tibial plateau slopes are risk factors for ACL injury in Filipino population, and the risk increases by 3%, 4% and 5% per 1-degree respectively. Age is significantly higher among those without ACL injury while in terms of gender, ACL injury is significantly higher among men.

Keywords: tibial plateau slope, anterior cruciate ligament injury, Filipino