Reliability and Agreement of Four Radiographic Methods for Measuring Posterior Tibial Slope on Lateral Knee Radiographs

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dc.contributor.authorYüksel, Yavuz
dc.contributor.authorKöse, Özkan
dc.date.accessioned2026-01-24T11:55:19Z
dc.date.available2026-01-24T11:55:19Z
dc.date.issued2025
dc.departmentAlanya Alaaddin Keykubat Üniversitesi
dc.description.abstractObjective: The posterior tibial slope (PTS) is a critical anatomical parameter influencing knee biomechanics and ligamentous stability. Despite its clinical relevance, no consensus exists on the most reliable radiographic method for measuring PTS. This study aimed to evaluate the inter- and intra-observer reliability and agreement of four radiographic techniques for PTS measurement on standard lateral knee radiographs. Material and Method: A retrospective analysis was conducted on 70 adult patients with high-quality true lateral knee radiographs. Four commonly used methods were applied to measure the PTS: the fibular shaft axis (FSA), anterior cortical line (ACL), posterior cortical line (PCL), and proximal anatomical axis (PAA). Two experienced observers performed all measurements twice, 15 days apart, using a standardized protocol. Intraclass correlation coefficients (ICCs) were calculated to assess reliability, and Pearson correlation coefficients were used to evaluate the agreement between measurements and demographic characteristics. Results: All four methods showed excellent intra-observer reliability (ICC, range 0.916–0.975) and good-to-excellent inter-observer reliability (ICC, range 0.813–0.968). Mean PTS values differed by method: ACL 12.4° ± 3.2°, PCL 7.2° ± 3.1°, FSA 10.1° ± 3.2°, PAA 9.6° ± 3.0° (p = 0.001). Pairwise correlations were strong for all methods (p < 0.001). PTS showed no significant association with age, sex, height, weight, or body mass index. Conclusions: Although reliability was high for all techniques, differences in absolute values indicate that methods are not interchangeable. Standardized reference axes should be specified to ensure consistent reporting across clinical and research settings.
dc.identifier.doi10.17343/sdutfd.1771453
dc.identifier.endpage335
dc.identifier.issn1300-7416
dc.identifier.issn2602-2109
dc.identifier.issue4
dc.identifier.startpage327
dc.identifier.urihttps://doi.org/10.17343/sdutfd.1771453
dc.identifier.urihttps://hdl.handle.net/20.500.12868/2848
dc.identifier.volume32
dc.language.isoen
dc.publisherSüleyman Demirel University
dc.relation.ispartofSüleyman Demirel Üniversitesi Tıp Fakültesi Dergisi
dc.relation.ispartofMedical Journal of Süleyman Demirel University
dc.relation.publicationcategoryMakale - Ulusal Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_DergiPark_20260121
dc.subjectOrthopaedics
dc.subjectOrtopedi
dc.subjectRadiology and Organ Imaging
dc.subjectRadyoloji ve Organ Görüntüleme
dc.titleReliability and Agreement of Four Radiographic Methods for Measuring Posterior Tibial Slope on Lateral Knee Radiographs
dc.typeArticle

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