The Geometry of the Tibial Plateau and Its Influence on the Biomechanics of the Tibiofemoral Joint
The Geometry of the Tibial Plateau and Its Influence on the Biomechanics of the Tibiofemoral Joint
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DOI：
10.2106/jbjs.g.01358
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发表时间：
2008-12-01
影响因子：
5.3
通讯作者：
Dabezies, Eugene
中科院分区：
文献类型：
--
作者：
Hashemi, Javad;Chandrashekar, Naveen;Dabezies, Eugene
背景：胫骨平台的几何形状复杂且不对称。先前的研究已经基于单个参数（后倾角）表征了矢状面中胫骨平台几何形状的受试者间差异。我们假设：（1）内侧平台的倾斜度、凹陷深度和外侧平台的凸度存在较大的受试者间差异;（2）胫骨内侧倾斜度和外侧倾斜度在受试者中存在差异;（3）胫骨平台的倾斜度以及凹凸度存在性别差异;（4）年龄与所测参数无关。使用矢状面和冠状面磁共振图像测量了33名女性和22名男性受试者的胫骨平台的内侧、外侧和冠状面斜坡以及骨质部分的深度，并评估了这四个参数的性别差异。还评估了受试者内内侧和外侧胫骨斜率之间的差异。进行相关性检验，以检查存在的线性关系之间的各种斜率以及斜率和subject age.Results：的胫骨斜率的受试者到受试者的变化范围是实质性的男性和女性。然而，女性受试者的平均胫骨内侧和外侧斜率大于男性受试者（p < 0.05）。女性患者的胫骨冠状面斜率小于男性患者（P < 0.05）。胫骨内侧和外侧倾斜度之间的相关性较差。胫骨内侧和外侧倾斜度之间的受试者内差异具有显著性（p < 0.05）。两种性别的胫骨平台内侧深度无差异。胫骨外侧部分的软骨下骨，在关节区域内，大部分是平坦的。年龄与观察到的results.Conclusions：胫骨平台的骨性部分的几何形状更有力地解释了三个斜坡和胫骨内侧髁的深度。临床相关性：在本研究中发现的胫骨平台几何形状的性别和受试者对受试者的差异可能是重要的考虑在评估膝关节损伤的风险。骨关节炎的易感性，以及单髁和全膝关节置换术的成功。
Background: The geometry of the tibial plateau is complex and asymmetric. Previous research has characterized subject-to-subject differences in the tibial plateau geometry in the sagittal plane on the basis of a single parameter, the posterior slope. We hypothesized that (1) there are large subject-to-subject variations in terms of slopes, the depth of concavity of the medial plateau, and the extent of convexity of the lateral plateau; (2) medial tibial slope and lateral tibial slope are different within subjects; (3)there are sex-based differences in the slopes as well as concavities and convexities of the tibial plateau; and (4) age is not associated with any of the measured parameters.Methods: The medial, lateral, and coronal slopes and the depth of the osseous portion of the tibial plateau were measured with use of sagittal and coronal magnetic resonance images that were made for thirty-three female and twenty-two male subjects, and differences between the sexes with respect to these four parameters were assessed. Within subject differences between the medial and lateral tibial slopes also were assessed. Correlation tests were performed to examine the existence of a linear relationship between various slopes as well as between slopes and subject age.Results: The range of subject-to-subject variations in the tibial slopes was substantive for males and females. However, the mean medial and lateral tibial slopes in female subjects were greater than those in male subjects (p < 0.05). In contrast, the mean coronal tibial slope in female subjects was less than that in male subjects (p < 0.05). The correlation between medial and lateral tibial slopes was poor. The within-subject difference between medial and lateral tibial slopes was significant (p < 0.05). No difference in medial tibial plateau depth was found between the sexes. The subchondral bone on the lateral part of the tibia, within the articulation region, was mostly flat. Age was not associated with the observed results.Conclusions: The geometry of the osseous portion of the tibial plateau is more robustly explained by three slopes and the depth of the medial tibial condyle.Clinical Relevance: The sex and subject-to-subject-based differences in the tibial plateau geometry found in the present study could be important to consider during the assessment of the risk of knee injury. the susceptibility to osteoarthritis, and the success of unicompartmental and total knee arthroplasty.