{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:15:12Z","timestamp":1777929312769,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Osteoarthritis (OA) is a leading cause of chronic pain and disability worldwide, particularly among aging populations. Early identification of structural alterations may enable timely intervention and reduce irreversible joint damage. The posterior tibial slope (PTS) and metaphysio-diaphyseal angle (MDA) have been proposed as radiographic biomarkers of knee OA; however, population-specific data from South India are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate PTS and MDA as radiological markers of knee osteoarthritis in South Indian adults, compare these parameters between osteoarthritic and non-osteoarthritic knees, assess their interrelationship, and determine their diagnostic performance in predicting OA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A hospital-based cross-sectional comparative study was conducted among 384 adults aged \u226530 years attending the Orthopaedics Department at Chettinad Hospital &amp; Research Institute, Chennai, between June 2022 and January 2024. Equal numbers of osteoarthritic knees (n = 192) and non-OA controls (n = 192) underwent standardized anteroposterior and lateral knee radiography. PTS and MDA were measured digitally using validated techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean PTS was significantly higher in osteoarthritic knees compared with controls (15.98 \u00b1 2.18\u00b0 vs 9.78 \u00b1 2.73\u00b0, p &lt; 0.001). Similarly, MDA was significantly elevated in the OA group (24.86 \u00b1 4.13\u00b0 vs 21.44 \u00b1 4.30\u00b0, p &lt; 0.001). A moderate positive correlation was observed between PTS and MDA (r = 0.275, p &lt; 0.001; R\n                      <jats:sup>2<\/jats:sup>\n                      = 0.075). ROC analysis demonstrated excellent discriminative ability for PTS (AUC = 0.963) and moderate discriminative ability for MDA (AUC = 0.717). Female participants constituted 52.5% of the OA group, consistent with established sex-related prevalence patterns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Posterior tibial slope and metaphysio-diaphyseal angle are significantly increased in osteoarthritic knees among South Indian adults, with PTS showing superior diagnostic accuracy. These parameters may serve as useful adjunctive radiographic markers for early OA detection and risk stratification. Further longitudinal studies are warranted to establish population-specific predictive thresholds.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10225536261439404","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T05:37:22Z","timestamp":1775108242000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiographic assessment of posterior tibial slope and metaphysio-diaphyseal angle as structural markers of knee osteoarthritis in South Indian adults: A cross-sectional comparative study"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8164-6863","authenticated-orcid":false,"given":"Nithesh Jay","family":"Bensam","sequence":"first","affiliation":[{"name":"Chettinad Hospital and Research Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0312-2428","authenticated-orcid":false,"given":"E.","family":"Pradeep","sequence":"additional","affiliation":[{"name":"Chettinad Hospital and Research Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aswin","family":"Vijay","sequence":"additional","affiliation":[{"name":"Government T.D Medical College and Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arun","family":"Kumar K V","sequence":"additional","affiliation":[{"name":"Chettinad Hospital and Research Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheik","family":"Mohideen","sequence":"additional","affiliation":[{"name":"Chettinad Hospital and Research Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"e_1_3_7_2_2","first-page":"205","article-title":"Knee osteoarthritis prevalence, risk factors, pathogenesis and features: part I","volume":"2","author":"Heidari B","year":"2011","unstructured":"Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: part I. Caspian journal of internal medicine 2011; 2: 205\u2013212.","journal-title":"Caspian journal of internal medicine"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2010.03.001"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204763"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1517\/14656560903018911"},{"key":"e_1_3_7_6_2","first-page":"1574","article-title":"Osteoarthritis of the knee joint as a cause of musculoskeletal ambulation disability symptom complex (MADS)","volume":"18","author":"Hayami T","year":"2008","unstructured":"Hayami T. Osteoarthritis of the knee joint as a cause of musculoskeletal ambulation disability symptom complex (MADS). 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Am J Knee Surg 1999; 12: 165\u2013168.","journal-title":"Am J Knee Surg"},{"key":"e_1_3_7_13_2","first-page":"28","article-title":"Correlation of posterior tibial slope with metaphysio-diaphyseal angle in total knee arthroplasty: a radiological study","volume":"5","author":"Juneja J","year":"2017","unstructured":"Juneja J, Mustafa S, Gupta R. Correlation of posterior tibial slope with metaphysio-diaphyseal angle in total knee arthroplasty: a radiological study. 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