title: Association Between Tibial Plateau Slopes and Anterior Cruciate Ligament Injury: A Meta-analysis.
abstract: OBJECTIVE
  To investigate the associations of medial tibial plateau slope (MTPS), lateral tibial plateau slope (LTPS), and coronal tibial plateau slope (CTPS) with anterior cruciate ligament (ACL) injury both in the general population and in different gender subgroups.
  
  
  METHODS
  PubMed, Ovid, Embase, and Scopus databases were searched through from inception to August 31, 2016. Observational studies reporting associations of MTPS/LTPS/CTPS with ACL injury were retrieved for analysis. Either a fixed- or random-effects model was used to calculate the overall standardized mean difference (SMD). Reviews, meeting abstracts, cadaver or animal studies, and other studies without disclosing full text were excluded in this study.
  
  
  RESULTS
  A total of 29 studies were included. Subjects with ACL injury exhibited a significant increase in MTPS (SMD: 0.34 [95% confidence interval (CI): 0.18, 0.49]; P < .0001) and LTPS (SMD: 0.49 [95% CI: 0.30, 0.68]; P < .00001), but not in the CTPS (SMD: 0.09 [95% CI: -0.10, 0.27]; P = .36), compared with controls. Meanwhile, significant differences in MTPS and LTPS were observed in the male subgroup (SMD: 0.41 [95% CI: 0.20, 0.62]; P = .0001 and SMD: 0.55 [95% CI: 0.26, 0.85]; P = .0002, respectively) but not in the female (SMD: 0.31 [95% CI: -0.02, 0.64]; P = .06 and SMD: 0.26 [95% CI: -0.04, 0.56]; P = .09, respectively).
  
  
  CONCLUSIONS
  The present meta-analysis showed that the increases in MTPS and LTPS were overall risk factors of ACL injury. However, these slopes would only be considered as "at risk" for males, but not for females. In addition, it was also proved that CTPS was not a risk factor of ACL injury.
  
  
  METHODS
  Level III, meta-analysis of Level II and III studies.
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Yi-Lun
authors.initials: YL
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Tuo
authors.initials: T
authors.lastname: Yang
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zeng
authors.affiliation: Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, China; Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Dong-Xing
authors.initials: DX
authors.lastname: Xie
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Yuan-Heng
authors.initials: YH
authors.lastname: Yang
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Hui-Zhong
authors.initials: HZ
authors.lastname: Long
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Bei
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Yu-Xuan
authors.initials: YX
authors.lastname: Qian
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Shi-de
authors.initials: SD
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China; Center for Clinical Technology and Research of Joint Surgery of Hunan Province, Changsha, Hunan Province, China. Electronic address: lgh9640@sina.cn.
authors.forename: Guang-Hua
authors.initials: GH
authors.lastname: Lei
mesh_terms: D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery