Abstract
Medial proximal tibial angle (MPTA) and posterior proximal tibial angle (PPTA) are
commonly used to characterize the geometry of proximal tibia and are important considerations
in lower extremity realignment procedures and total knee arthroplasty. This study
utilized a large cadaveric collection to explore relationships between tibial slope
and coronal plane deformity of the tibia. We utilized 462 well-preserved skeletons
(924 tibiae), excluding any with fracture or obvious rheumatologic or infectious findings.
Custom cards were made with different sized arcs on the bottom surface, so that they
could rest on the anterior and posterior aspects of the medial and lateral tibial
plateaus of each bone to measure PPTA. Previously measured MPTA values for the same
bones were also utilized. Multiple regression analysis was used to determine relationship
between MPTA and medial and lateral PPTAs. The mean age was 56 ± 10 years, with 13%
female and 31% African American (remainder Caucasian). The mean MPTA was 87.2 ± 2.4
degrees. The mean medial plateau PPTA was 81.5 ± 3.8 degrees and mean lateral plateau
PPTA was 81.3 ± 3.7 degrees. Regression analysis found that MPTA was significantly
associated with both medial and lateral PPTAs (standardized betas 0.197 and 0.146,
respectively, p < 0.0005 for both). There was a significant correlation between lateral and medial
PPTAs (r = 0.435, p = 0.03). The clinical significance of these findings warrants further investigation
and emphasizes the importance of carefully assessing the sagittal plane when planning
reconstruction of a tibia with varus or valgus deformity, particularly high tibial
osteotomies.
Keywords
proximal tibia - medial proximal tibial angle - posterior proximal tibial angle -
coronal plane - sagittal plane
