Publication:

Assessment of proximal tibial morphology and its association with anterior cruciate ligament injury: a magnetic resonance imaging-based comparative study

Background Anterior cruciate ligament (ACL) injuries are common in active individuals and may be influenced by proximal tibial morphology. Increased posterior tibial slope (PTS) is linked to greater ACL strain and higher injury risk. This study aims to assess the association between proximal tibial morphology and ACL injury using magnetic resonance imaging (MRI) in a North Indian population.

Methods A hospital-based cross-sectional study was conducted in the Orthopaedics Department of a tertiary care hospital in North India from November 2022 to January 2024. Eighty patients aged 20-60 were enrolled, divided into ACL injury (cases) and non-injury (controls) groups. MRI was used to assess proximal tibial morphology, focusing on PTS. Data were analyzed using unpaired t tests, Chi-square tests, logistic regression, and Pearson’s correlation. A p<0.05 was considered statistically significant.

Results Most ACL injuries occurred in the 30-45 age group (45%), with fewer in 45-60 group (12.5%). Males were more affected (58%) than females (42%). Overweight individuals made up 72.5% of ACL cases. Posterior tibial medial slope showed no significant association with ACL injury (OR=1.150, p=0.882), while lateral slope showed a trend toward a protective effect (OR=0.135, p=0.093). Correlation analysis revealed a weak positive correlation for medial slope (r=0.024) and a moderate negative correlation for lateral slope (r=-0.190).

Conclusions ACL injuries were more frequent in younger, overweight males. Lateral tibial slope showed a potential link to injury risk, suggesting proximal tibial morphology may influence ACL injury.