Perspective From:
Robert F. LaPrade, MD, PhD, and Luke Tollefson, BS
Abstract:
The article “Increased posterior tibial slope is associated with increased risk of meniscal root tears” by Jorge Chahla MD, PhD, and colleagues helps to assimilate data in the literature on the fact that increased posterior tibial slope is not only associated with ACL tears, but also with meniscal root tears.
Increased posterior tibial slope places increased stress on the ACL, which has been documented to both increase the risk of an ACL tear, as well as to place an ACL reconstruction graft at an increased risk of attenuation or a retear. The information presented in this article summarizes information that should be intuitive: The anteriorly directed stress that is present on the knee with an increased posterior tibial slope can also put extra stress on the posterior meniscal root attachments.
This information should prove useful for the clinical assessment of meniscal root tears, especially those that occur concurrent with an ACL tear, even prior to obtaining an MRI scan. In patients with minimal joint line pain, but who have increased posterior knee pain, especially with squatting activities, one can assess the posterior tibial slope of the knee to help improve one’s diagnostic capabilities for a root tear. In addition, it is well documented that in patients with an ACL tear, a Lachman or pivot shift test that is a 3+ is not just an ACL tear; it is an “ACL+” in that something else needs to be injured to achieve that increase in abnormal motion.
Assessing posterior tibial slope can help improve one’s diagnostic capabilities for posterior meniscus root tears.
You can view the original article:
Proximal tibial bony anatomy may predict risk of posterior meniscal root tears
