Posterior tibial slope in the Emirati population: The slope is over 12 degrees.

Abstract

Introduction: Posterior tibial slope (PTS) has been reported to be an important risk factor for anterior cruciate ligament (ACL) reconstruction (ACLR) failure. PTS varies between populations, and a mean value in the Emirati population has not been described. To evaluate PTS and to improve clinical decision-making regarding surgical thresholds for slope correcting osteotomy, a mean value for the Emirati population needs to be defined.

Methods: This was an institutional review board-approved retrospective study of 213 consecutive Emirati patients with knee complaints visiting a single orthopedic center in 2025. Inclusion criteria were patients >18 years of age visiting the center for the first time with no previous surgery or fracture in the affected knee. Medial and lateral PTS were measured on long weight-bearing lateral tibial radiographs using the proximal and long anatomical tibial axis and mechanical tibial axis.

Results: A total of 213 patients, 73 women and 140 men, were evaluated with a mean age of 46.0 years. The mean medial PTS was 12.8° ± 2.9° (range: 3.7-19.7°), and the mean lateral PTS was 11.9° ± 3.2° (range: 3.9-20.1°) using the proximal tibial axis. Using the long anatomical tibial axis, the mean medial PTS was 14.7° ± 3.3° (range: 4.8-25.5°), and the mean lateral PTS was 13.8° ± 3.7° (range: 5.1-24.8°). Using the mechanical tibial axis, the mean medial PTS was 12.7° ± 3.1° (range: 2.7-19.7°) and the mean lateral PTS was 12.2° ± 3.1° (range: 3.8-20.1°). Sex did not influence the PTS value (p > 0.05).

Discussion: In this Emirati population, the mean medial PTS was 12.7-14.7° and the mean lateral PTS was 11.9-13.8° for the differing measurement techniques. These values are higher than other reported populations and can be used as a reference when evaluating knee injuries and contribute to surgical decision-making in ACL-deficient knees.