Inter- and intra-observer reliability of measuring posterior tibial slope, anterior tibial translation, and tibiofemoral rotation utilizing weight bearing CT

Richard J. VanTienderen; Tyce C. Marquez; Bruno Butturi Varone; Shannon F. Ortiz; Donald D. Anderson; Robert W. Westermann; Brian R. Wolf; Renata Vidal Leao Sanford

doi:10.1016/j.ejrad.2026.112877

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Inter- and intra-observer reliability of measuring posterior tibial slope, anterior tibial translation, and tibiofemoral rotation utilizing weight bearing CT

Journal article

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Inter- and intra-observer reliability of measuring posterior tibial slope, anterior tibial translation, and tibiofemoral rotation utilizing weight bearing CT

Richard J. VanTienderen, Tyce C. Marquez, Bruno Butturi Varone, Shannon F. Ortiz, Donald D. Anderson, Robert W. Westermann, Brian R. Wolf and Renata Vidal Leao Sanford

European journal of radiology, Vol.200, 112877

07/01/2026

DOI: 10.1016/j.ejrad.2026.112877

PMID: 42013582

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Abstract

To assess the inter- and intra-observer reliability of measuring medial and lateral posterior tibial slope (PTS), medial and lateral anterior tibial translation (ATT), and tibiofemoral rotation (TFR) in non-injured and ACL-reconstructed knees using weight-bearing CT in fully extended and semi-flexed poses. Bilateral weight-bearing CT scans were obtained from 92 patients approximately three months after ACL reconstruction. For 38 patients, medial and lateral PTS, ATT, and TFR were measured on both extended and flexed scans of the non-injured and reconstructed knees by two independent observers to assess inter-observer reliability. Ten extended and ten flexed scans were reanalyzed by each observer to determine intra-observer reliability. Intraclass correlation coefficients (ICCs) were calculated for all parameters. ICCs demonstrated good to excellent inter-observer reliability for all parameters in both non-injured and ACL-reconstructed knees across positions. Lateral and medial ATT and TFR showed particularly high reliability, while medial ATT in extension was slightly lower. Intra-observer reliability was also good to excellent across nearly all measures, except for lateral PTS, which showed moderate reliability for one observer. Weight-bearing CT provides a reliable method for measuring PTS, ATT, and TFR in both non-injured and ACL-reconstructed knees.

Anterior cruciate ligament

Anterior Tibial Translation

Posterior Tibial Slope

Tibiofemoral rotation

Weight-bearing CT

Details

Title: Subtitle: Inter- and intra-observer reliability of measuring posterior tibial slope, anterior tibial translation, and tibiofemoral rotation utilizing weight bearing CT
Creators: Richard J. VanTienderen - University of Iowa
Tyce C. Marquez - University of Iowa
Bruno Butturi Varone - University of Iowa, Orthopedics and Rehabilitation
Shannon F. Ortiz - Departments of Orthopedics and Rehabilitation
Donald D. Anderson - University of Iowa
Robert W. Westermann - Departments of Orthopedics and Rehabilitation
Brian R. Wolf - Departments of Orthopedics and Rehabilitation
Renata Vidal Leao Sanford - Radiology The University of Iowa, Iowa City, IA 52242 USA
Resource Type: Journal article
Publication Details: European journal of radiology, Vol.200, 112877
DOI: 10.1016/j.ejrad.2026.112877
PMID: 42013582
ISSN: 0720-048X
eISSN: 1872-7727
Publisher: Elsevier B.V; CLARE
Grant note: Arthritis Foundation
Portions of this work were supported by a grant from the Arthritis Foundation.
Language: English
Date published: 07/01/2026
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Orthopedics and Rehabilitation; Industrial and Systems Engineering; Physical Therapy and Rehabilitation Science; Athletic Training Program
Record Identifier: 9985157616502771

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