Hashemi Javad, Chandrashekar Naveen, Gill Brian, Beynnon Bruce D, Slauterbeck James R, Schutt Robert C, Mansouri Hossein, Dabezies Eugene
Department of Mechanical Engineering, Texas Tech University, 7th and Boston Streets, Lubbock, TX 79409-1021, USA.
J Bone Joint Surg Am. 2008 Dec;90(12):2724-34. doi: 10.2106/JBJS.G.01358.
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.
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.
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.
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.
胫骨平台的几何形状复杂且不对称。以往的研究基于单一参数——后倾角，描述了矢状面上胫骨平台几何形状的个体差异。我们假设：（1）在坡度、内侧平台凹陷深度和外侧平台凸起程度方面存在较大的个体差异；（2）个体的内侧胫骨坡度和外侧胫骨坡度不同；（3）胫骨平台的坡度以及凹陷和凸起存在性别差异；（4）年龄与任何测量参数均无关联。
利用为33名女性和22名男性受试者拍摄的矢状面和冠状面磁共振成像，测量胫骨平台的内侧、外侧和冠状面坡度以及骨部分的深度，并评估这四个参数的性别差异。还评估了个体内侧和外侧胫骨坡度之间的差异。进行相关性测试，以检验各种坡度之间以及坡度与受试者年龄之间是否存在线性关系。
男性和女性胫骨坡度的个体差异范围较大。然而，女性受试者的平均内侧和外侧胫骨坡度大于男性受试者（p < 0.05）。相比之下，女性受试者的平均冠状胫骨坡度小于男性受试者（p < 0.05）。内侧和外侧胫骨坡度之间的相关性较差。个体内侧和外侧胫骨坡度之间的差异显著（p < 0.05）。未发现两性之间内侧胫骨平台深度存在差异。胫骨外侧关节区域内的软骨下骨大多是平的。年龄与观察结果无关。
胫骨平台骨部分的几何形状可以通过三个坡度和内侧胫骨髁的深度更有力地解释。
