Measurement of posterior tibial slope in north Indian population in relation to squatting

Vol 35 | Issue 2 | May-Aug 2020 | page: 14-18 | Khalid Ahmad Qidwai¹, Shakeel Ahmad Qidwai²


Authors: Khalid Ahmad Qidwai¹, Shakeel Ahmad Qidwai²

¹King George Medical University, Lucknow, UttarPradesh,India.
²Department of Orthopedics Surgery, Era’s University, Lucknow, UttarPradesh,India.

Address of Correspondence:
Dr. Khalid Ahmad Qidwai,
King George Medical University, Lucknow, UttarPradesh,India.
E-mail: khalid.99.q@gmail.com


Abstract:

Background: Tibial plateau, proximal tibial surface, has a slope directed postero-inferiorly relative to the long axis of the middle of the shaft. It has important consideration in surgeries such as knee arthroplasty, high tibial osteotomy, and medical imaging of the knee joint [1]. The aim of the present study was to estimate the Posterior Tibial Slope (PTS) by plain radiograph in the adult Northern Indian population with respect to lifestyle depending upon the squatting habit. It has significance in antero-posterior stability of the knee joint [2]. The current study aims to measure the Posterior Tibial slope in North Indian people and compare the PTS among the groups of people who squat and who do not squat in their day to day activities and draw a conclusion if it has a clinical significance in range of flexion of knee joint in knee arthroplasty.
Material and Method: this study was conducted at the Department of Anatomy, King George Medical University, Lucknow in collaboration with Department of Orthopaedics, Era University Lucknow. Measurements were taken in 37 patients on X-rays with a mean age of 46.5 years. Of the total subjects, 22 were squatters and 15 are non-squatters. Total of 70 X-rays (Knee Joint-Lateral View) were taken in which 43 X-rays were of squatters and 27 X-rays were of non-squatters with 34 X-Rays of left Side and 36 X-rays of right side. (Master Chart enclosed). Reference line taken to measure PTS was Posterior Tibial Cortex (PTC). A line was drawn tangential to PTC. Another line was drawn perpendicular to the first line passing through the anterior most point of the tibial slope. Then a line was drawn tangential to the tibial slope and the PTS was then measured by a protractor.
Results: PTS of non-squa_ers came out to be 9.25°±2.99 while those of squatters 11.67°±2.82. Average PTS was 10.74°±3.1° with 10.08°±3.28 in the left knee and 11.36°±2.83 in the right knee.
Conclusion: The present study described the variation of PTS in north Indian population (Uttar Pradesh) which came out to be 10.74°±3.1°. The PTS of squatters was 11.6°±2.82° and that of non-squatters 9.25°±2.99°. This difference in values of PTS is statistically significant (P=0.0011). Poor or no correlation of PTS was found with age and sex. The difference in PTS values in left and right knee was found to be statistically insignificant (P=0.0844). It may be concluded that in this pilot study squatting has been found to be significant as a cause of increased PTS which may be considered as an indicator for designing TKA implants which accommodate the increased PTS to increase range of flexion. However, authors do recommend MRI/CT Scan based prospective studies on measurement of preoperative PTS and its significance on maximal angle of flexion in post TKA knee joints.
Keywords: Tibial slope, Squatting, Knee arthroplasty.


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How to Cite this Article: Qidwai KA, Qidwai SA | Measurement of posterior tibial slope in north Indian population in relation to squatting | Journal of Bone and Joint
Diseases | May-Aug 2020;35(2):14-18.


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