Evaluating the Role of Tibial Geometry in Anterior Cruciate Ligament Injuries: Focus on Medial and Lateral Posterior Tibial Slopes and Plateau Depth

Background:The anterior cruciate ligament (ACL) is a key stabilizer of the knee joint, preventing anterior translation of the tibia relative to the femur.While ACL injuries may result from both contact and noncontact mechanisms, recent studies have emphasized the role of tibial geometric anatomy in predisposing individuals to such injuries.This study aims to assess and compare tibial anatomical parameters-including medial and lateral posterior tibial slopes (MPTS and LPTS) and medial tibial plateau depth-using magnetic resonance imaging (MRI) in patients with ACL tears versus those with intact ACLs.Methodology: A total of 70 patients were enrolled and divided into two groups: the ACL injury group and a control group with intact ACLs.MRI scans were reviewed in a blinded manner to measure LPTS, MPTS, and medial tibial plateau depth.The values obtained were statistically analyzed and compared between the two groups.Results: Patients with ACL injuries exhibited significantly higher values of both LPTS and MPTS compared to the control group (p < 0.05).However, there was no statistically significant difference in medial tibial plateau depth between the groups (p = 0.45).The mean LPTS, MPTS, and medial plateau depth in the ACL injury group were 7.3, 6.78, and 2.66 mm, respectively.In contrast, the control group had mean values of 3.54, 4.17, and 2.5 mm, respectively.Conclusion: Increased posterior tibial slopes (both medial and lateral) are associated with a higher risk of ACL injury, whereas medial plateau depth appears to have no significant correlation.These anatomical parameters may serve as useful predictive tools in identifying individuals at greater risk for ACL injuries.