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Peer-reviewedCC BYKnee surgery & related research

Medial-lateral posterior tibial slope asymmetry is associated with the presence of medial meniscus posterior root tear.

  • Kento Harada1
  • Yu Mori2
  • Takahisa Abe3,4
  • Takashi Aki3
  • Masayuki Kamimura3
  • Masanori Ogasawara5
  • Kentaro Ito5
  • Toshimi Aizawa3
5 affiliations
  1. 1Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. [email protected].
  2. 2Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. [email protected].
  3. 3Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
  4. 4Iwate Prefectural Central Hospital, Morioka, Japan.
  5. 5Sendai Orthopaedic Hospital, Sendai, Japan.
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Abstract

Background

Posterior tibial slope (PTS) has been identified as an important anatomical risk factor for medial meniscus posterior root tear (MMPRT). However, prior studies have primarily focused on the medial slope. The primary aim of this study was to measure medial and lateral PTS on magnetic resonance imaging (MRI) and to determine whether medial-lateral slope asymmetry is associated with MMPRT.Methods

This multicenter retrospective study included patients aged 50-75 years who underwent knee MRI for knee pain at two institutions. Patients with osteoarthritis (Kellgren-Lawrence grade 3 or 4) were excluded. MMPRT was diagnosed on MRI. The medial PTS (MPTS), lateral PTS (LPTS), medial proximal tibial angle (MPTA), and lateral distal femoral angle (LDFA) were measured, and ΔPTS was defined as MPTS - LPTS. Groups were compared before and after 1:1 propensity score (PS) matching for age, sex, and body mass index. Multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were conducted to evaluate the association and discriminative ability of ΔPTS.Results

A total of 120 knees were included, of which 26 (21.7%) demonstrated MMPRT. MPTS did not differ significantly between groups, whereas the MMPRT group showed a significantly smaller LPTS (p < 0.001) and larger ΔPTS (p < 0.001). These findings remained consistent after 1:1 PS matching (22 matched pairs), with ΔPTS remaining significantly greater in the MMPRT group (p < 0.001). In multivariable analysis, ΔPTS was independently associated with MMPRT (odds ratio 2.17 per 1°, 95% CI 1.56-3.02, p < 0.001). ROC curve analysis demonstrated good discriminative performance of ΔPTS for identifying MMPRT (area under the curve [AUC] = 0.87, 95% CI 0.79-0.95), which exceeded that of LPTS (0.73) and MPTS (0.54) (DeLong p = 0.006 and p < 0.001, respectively). The exploratory cutoff value was 4.0°, yielding a sensitivity of 80.8% and a specificity of 81.9%.Conclusions

Knees with MMPRT exhibited a smaller LPTS and greater ΔPTS compared with knees without MMPRT, which remained significant after PS matching. ROC analysis demonstrated good discriminative performance, and a ΔPTS of 4.0° or greater may serve as an exploratory threshold. PTS asymmetry may represent a morphological factor associated with MMPRT.Level of evidence iii

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Cite

BibTeXRIS
BibTeX
@article{harada2026mediallateral,
  title = {{Medial-lateral posterior tibial slope asymmetry is associated with the presence of medial meniscus posterior root tear.}},
  author = {Kento Harada and Yu Mori and Takahisa Abe and Takashi Aki and Masayuki Kamimura and Masanori Ogasawara and Kentaro Ito and Toshimi Aizawa},
  journal = {Knee surgery \& related research},
  year = {2026},
  month = oct,
  doi = {10.1186/s43019-026-00352-2},
  url = {https://europepmc.org/article/MED/42958592},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Medial-lateral posterior tibial slope asymmetry is associated with the presence of medial meniscus posterior root tear.
AU  - Kento Harada
AU  - Yu Mori
AU  - Takahisa Abe
AU  - Takashi Aki
AU  - Masayuki Kamimura
AU  - Masanori Ogasawara
AU  - Kentaro Ito
AU  - Toshimi Aizawa
PY  - 2026
DA  - 2026/10/29
JO  - Knee surgery & related research
DO  - 10.1186/s43019-026-00352-2
UR  - https://europepmc.org/article/MED/42958592
AB  - Background  Posterior tibial slope (PTS) has been identified as an important anatomical risk factor for medial meniscus posterior root tear (MMPRT). However, prior studies have primarily focused on the medial slope. The primary aim of this study was to measure medial and lateral PTS on magnetic resonance imaging (MRI) and to determine whether medial-lateral slope asymmetry is associated with MMPRT.Methods  This multicenter retrospective study included patients aged 50-75 years who underwent knee MRI for knee pain at two institutions. Patients with osteoarthritis (Kellgren-Lawrence grade 3 or 4) were excluded. MMPRT was diagnosed on MRI. The medial PTS (MPTS), lateral PTS (LPTS), medial proximal tibial angle (MPTA), and lateral distal femoral angle (LDFA) were measured, and ΔPTS was defined as MPTS - LPTS. Groups were compared before and after 1:1 propensity score (PS) matching for age, sex, and body mass index. Multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were conducted to evaluate the association and discriminative ability of ΔPTS.Results  A total of 120 knees were included, of which 26 (21.7%) demonstrated MMPRT. MPTS did not differ significantly between groups, whereas the MMPRT group showed a significantly smaller LPTS (p < 0.001) and larger ΔPTS (p < 0.001). These findings remained consistent after 1:1 PS matching (22 matched pairs), with ΔPTS remaining significantly greater in the MMPRT group (p < 0.001). In multivariable analysis, ΔPTS was independently associated with MMPRT (odds ratio 2.17 per 1°, 95% CI 1.56-3.02, p < 0.001). ROC curve analysis demonstrated good discriminative performance of ΔPTS for identifying MMPRT (area under the curve [AUC] = 0.87, 95% CI 0.79-0.95), which exceeded that of LPTS (0.73) and MPTS (0.54) (DeLong p = 0.006 and p < 0.001, respectively). The exploratory cutoff value was 4.0°, yielding a sensitivity of 80.8% and a specificity of 81.9%.Conclusions  Knees with MMPRT exhibited a smaller LPTS and greater ΔPTS compared with knees without MMPRT, which remained significant after PS matching. ROC analysis demonstrated good discriminative performance, and a ΔPTS of 4.0° or greater may serve as an exploratory threshold. PTS asymmetry may represent a morphological factor associated with MMPRT.Level of evidence iii
SN  - 2234-0726
SN  - 2234-2451
ER  -