The effect of steep posteri̇or ti̇bi̇al slope i̇n pati̇ents wi̇th meni̇scal tears between 18-30 years of age

Meniscal tears are a condition that occurs mostly during athletic activities and is associated with anterior cruciate ligament (ACL) injuries. In general, risk factors for meniscal tears are divided into two as intrinsic and extrinsic. Determination of intrinsic anatomical factors such as posterior tibial slope (PTS) can assist orthopedic surgeons in diagnosing and determining the treatment algorithm in cases with suspected meniscal tear. The aim of our study is to investigate the effect of posterior tibial slope, measured in patients who underwent arthroscopic surgery for meniscal tear, on meniscal tear by comparing it with the control group. The study was conducted on 190 patients who applied to Gaziantep University Faculty of Medicine, Department of Orthopedics and Traumatology between 2015 and 2022 with knee pain complaints. Individuals without meniscal tear and ACL tear on Magnetic Resonance Imaging (MRI), and patients diagnosed with meniscal tear and operated arthroscopically were included in the study. Those with medial meniscal tears were named Group A (n=67), those with lateral meniscus tears were named Group B (n=31), and the control group was named Group C (n=92). Medial posterior tibial slope and lateral posterior tibial slope of each group were measured on lateral radiography. As a result of the measurements, the groups were statistically compared among each other and ROC analyzes were performed. It was investigated whether there is a correlation between meniscal tears and posterior tibial inclination angle among 190 patients who met the criteria for participation in the study. It was observed that there was a statistically significant difference between the medial posterior tibial slope and the lateral posterior tibial slope values of the groups (Medial meniscal tear, Group A; Lateral meniscal tear, Group B; Normal, Group C) (p<0.05). Both the medial posterior tibial slope and the lateral posterior tibial slope were found to be significantly higher in Group A and Group B compared to the normal group. In the ROC analysis, in which the medial posterior tibial slope of patients with medial meniscus tear and control group were evaluated; The cut-off value of the medial posterior tibial slope was found to be 9.2. Its sensitivity is 64.18%, and its specificity is 80.43% (p<0.01). In the ROC analysis in which the lateral posterior tibial slope was evaluated with the control group of patients with lateral meniscus tear; The cut-off value of the lateral posterior tibial tilt angle was 9.9, the sensitivity was 58.06%, and the specificity was 81.52% (p<0.01). It was concluded that steep posterior tibial slope is a predisposing factor in the formation of meniscal tears. However, if the medial posterior tibial slope measured on X-ray is above 9.2°, it shows a direction as a marker for medial meniscus pathology, with low sensitivity but high specificity. Likewise, if the lateral posterior tibial slope is over 9.9°, it strongly supports the lateral meniscus pathology. Key words: Meniscus Tear, Posterior Tibial Slope, PTS