与短侧位x线片测量值相比，长x线片和3D CT测量值高估了胫骨内侧后坡。

IF 2 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2024-12-18 DOI:10.1002/jeo2.70120

Ahmed Mabrouk, Arthur Chou, Wiemi Duouguih, Shintaro Onishi, Alfred Mansour, Matthieu Ollivier

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引用次数: 0

摘要

目的：本研究评估了使用长x线片和三维（3D）计算机断层扫描（CT）测量胫骨内侧后坡（MPTS），并将其与短侧膝x线片测量结果进行了比较。该研究旨在确定以前在短x线片上定义的危险斜率测量是否与长x线片和3D CT扫描相似。方法：回顾性分析52例计划行胫骨高位变斜截骨术的患者的放射学资料，并对其进行短、长侧位片和三维CT扫描。两名独立观察员测量了三种方式的MPTS。MPTS定义为胫骨平台内侧切线与参考胫骨解剖轴之间的夹角。将来自短片和长片的MPTS测量值相互比较，然后与CT扫描的测量值进行比较。假阳性定义为在CT扫描或长x线片上MPTS测量值为bb0 78°，而短x线片测量值≤78°的病例。这些假阳性病例是基于先前验证的短x线片斜率阈值≥12°而被错误地标记为具有异常斜率的病例。结果：共分析52例，男67.9%，女32.1%。平均年龄27±5.4岁。平均体重71.5±7.7 kg，平均身高1.8±0.1 m。短片平均MPTS为77.3±2.3°；x线长片为75.8±2.0°；CT扫描为75.3±2.1°。短片和长片测量值之间存在正相关（r = 0.9）（p r = 0.86, r = 0.87），短片测量值均为p 78°。结论：与短侧位x线片相比，长侧位x线片或3D CT扫描的MPTS测量值可能高估1.5-2°。考虑到长x线片和CT扫描的异常PTS测量值过高，应定义不同的阈值。证据等级：四级病例系列。

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Medial posterior tibial slope measurements are overestimated on long radiographs and 3D CT compared to measurements on short lateral radiographs

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Medial posterior tibial slope measurements are overestimated on long radiographs and 3D CT compared to measurements on short lateral radiographs

Purpose

This study assessed the measurements of the medial posterior tibial slope (MPTS) using long radiographs and three-dimensional (3D) computed tomography (CT) scans and compared them to measurements taken on short lateral knee radiographs. The study aimed to identify whether the at-risk slope measurements previously defined on the short radiographs would be similar to long radiographs and 3D CT scans.

Methods

A retrospective radiological review of 52 cases, who underwent planning for a slope-changing high tibial osteotomy and had short and long lateral radiographs and 3D CT scans of the tibia. Two independent observers measured the MPTS on the three modalities. The MPTS was defined as the angle between a tangent to the medial tibial plateau and the referenced tibia anatomical axis. The MPTS measurements from the short and long radiographs were compared to each other and then were compared to the measurements performed on the CT scan. False positives were defined as those cases with MPTS measurements of >78° on CT scans or long radiographs while having measurements ≤78° on short radiographs. These false positive cases are the ones which would be falsely labelled as having an abnormal slope based on the previously validated short radiograph slope threshold ≥12°.

Results

A total of 52 cases were analysed (67.9% males and 32.1% females). The mean age was 27 ± 5.4 years. The mean weight was 71.5 ± 7.7 kg, and the mean height was 1.8 ± 0.1 m. The mean MPTS measured on the short radiographs was 77.3 ± 2.3°; on the long radiographs, it was 75.8 ± 2.0°; and on the CT scan, it was 75.3 ± 2.1°. There was a positive correlation between the measurements taken on both the short and long radiographs (r = 0.9) (p < 0.001). Additionally, there was a positive correlation between CT tibial slope measurements and both short and long radiographs tibial slope measurements (r = 0.86, r = 0.87), respectively (both p < 0.001). False positives were 13 (25%) patients on long radiographs, and 12 (23.1%) patients on CT scans, who had their MPTS measurements ≤78° (equivalent of PTS ≥ 12°) while their measurements were >78° on the short radiographs.

Conclusion

Measurements of the MPTS can be overestimated by 1.5–2° on long lateral knee radiographs or 3D CT scans compared to measurements taken on short lateral radiographs. Different thresholds for the abnormal PTS measurements on long radiographs and CT scans, should be defined, considering the overestimated measurements in these modalities.