ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026
Proximal anatomical axes show bidirectional variability: Accurate tibial slope requires mechanical axis measurement.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Intraoperative fluoroscopically assessment underestimates the posterior tibial slope in open-wedge high tibial osteotomy.Journal of experimental orthopaedics · 2026Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo determine whether posterior tibial slope (PTS) measured to proximal anatomical axes can serve as a reliable proxy for PTS measured to the mechanical tibial axis (mTA).
methodsIn patients ≥18 years with failed anterior cruciate ligament reconstruction, medial and lateral PTS were measured relative to the mTA on a lateral lower-leg radiograph, and relative to the proximal tibial anatomical axis (PTAA), anterior tibial cortical axis (ATC) and posterior tibial cortical axis (PTC) on a lateral knee radiograph. Agreement was assessed using correlation coefficients, measurement error and Bland-Altman analysis. Diagnostic accuracy of the conventional ≥12° PTAA-based PTS cut-off for slope-reducing osteotomy was determined.
resultsFifty-nine knees were analyzed. Correlation between proximal anatomical axes and mTA-based PTS measurements was strong (r ≥ 0.71), but agreement was poor. Mean measurement error for PTAA was 0.1 ± 2.4° (range: -5.7° to 7.6°) and -0.5 ± 2.4° (range: -6.6° to 5.2°), for ATC -3.4 ± 2.6° (range: -8.6° to 5.9°) and -3.7 ± 2.6° (range: -9.9° to 2.7°) and for PTC 3.0 ± 2.6° (range: -2.9° to 10.4°) and 2.7 ± 2.4° (range: -3.6° to 7.8°) for the medial and lateral plateau, respectively. For PTAA, absolute measurement error ≥2° occurred in approximately 50% of knees. Bland-Altman analysis showed 95% levels of agreement ranging from -4.89° to 4.62° (medial) and -5.11° to 4.11° (lateral). Using the ≥12° cut-off on PTAA-based PTS values misclassified approximately one in three knees (19.5% false-positive and 13.2% false-negative) relative to the mTA-based PTS reference values.
conclusionDespite strong correlation, proximal anatomical axes-based PTS measurements on routine lateral knee radiographs show substantial, bidirectional measurement error outside clinically acceptable limits of agreement compared to mTA-based PTS measurements on full-length lateral lower-leg radiographs. Single-exposure, full-length lateral lower-leg radiographs should be obtained to measure PTS relative to the mTA when considering slope-reducing osteotomy. LEVEL OF EVIDENCE: Level IV.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.