Posterior tibial slope

Relevance of posterior tibial slope

The amount of tibial slope has a bearing on knee stability, and in particular the stability of the anterior cruciate ligament (ACL).

An abnormal degree of slope may make the ACL more prone to injury.

• Quote from peer-reviewed paper:

  "....Higher tibial slopes in injured soccer players compared to the uninjured players may indicate a relationship between the tibial slope and ACL injury risk....On players who display higher tibial slopes, additional exercises targeting enhancement of neuromuscular stability should be advised...."

  Citation: Senişik S, Ozgürbüz C, Ergün M, Yüksel O, Taskiran E, Işlegen C, Ertat A. Posterior tibial slope as a risk factor for anterior cruciate ligament rupture in soccer players. J Sports Sci Med. 2011 Dec 1;10(4):763-7. PMID: 24149571; PMCID: PMC3761495.

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Measurement of posterior tibial slope

To measure the angle of tibial slope, a line is drawn on an X-ray along the front of the tibia (anterior tibial cortex line) (A).

Then a line is drawn perpendicular to the anterior tibial cortex line (B). Finally a line is drawn along the top of the tibial plateau (C), and the angle of the posterior tibial slope is the angle formed by B and C.

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Correcting tibial slope for ACL reconstruction

If the surgeon is concerned that an abnormal tibial slope might prejudice the outcome of an ACL (anterior cruciate ligament) reconstruction, then a high tibial osteotomy might be performed to correct the slope before the cruciate injury is dealt with.

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