Sports Medicine Center, OrthoCarolina Sports Medicine Center, Charlotte, NC, USA.
Orthopaedic & Sports Medicine Clinic of Kansas City, Kansas City, KS, USA.
Cartilage. 2021 Apr;12(2):175-180. doi: 10.1177/1947603519833147. Epub 2019 Mar 12.
Tibial plateau osteochondral allograft transplantation is a promising treatment for symptomatic chondral damage of the proximal tibia due to a variety of etiologies. The purpose of this investigation is to develop an accurate and reproducible algorithm for sizing tibial plateau allografts based on recipient radiographs.
A cadaveric study was performed in which radiographs of 10 fresh frozen cadaveric knees were compared to measured digital photographs of the disarticulated specimens. By comparing the average distance between standard anatomical landmarks on the radiographs to the gross specimens, a correlation factor was calculated that could be applied to recipient radiograph measurements for more accurate sizing of tibial plateau allografts.
In the coronal plane there were no differences between the mean radiographic and mean morphologic measurements of either the medial or lateral tibial plateau. However, in the sagittal plane the anatomic specimens of the medial and lateral plateau were 90% and 80%, respectively, of the measurements made from the lateral radiograph.
This cadaveric investigation is the first to propose a sizing algorithm for tibial plateau osteochondral allografts. Based on the results, an anteroposterior radiograph can reliably measure the width of both the medial and lateral tibial plateau without any correction needed. The average morphological lengths of the medial and lateral tibial plateau, on the other hand, were found to be 90% and 80%, respectively, of the radiographically measured lengths. Without correction, this would lead to the implantation of oversized grafts that may contribute to early failure.
胫骨平台骨软骨同种异体移植是一种有前途的治疗方法，适用于多种病因引起的胫骨近端症状性软骨损伤。本研究的目的是开发一种基于受者 X 线片的胫骨平台同种异体移植物准确且可重复的尺寸确定算法。
进行了一项尸体研究，将 10 例新鲜冷冻尸体膝关节的 X 线片与关节离断标本的测量数字照片进行比较。通过比较 X 线片上标准解剖标志之间的平均距离与大体标本，计算出一个相关系数，可应用于受者 X 线片测量，以更准确地确定胫骨平台同种异体移植物的尺寸。
在冠状面，内侧和外侧胫骨平台的 X 线片平均测量值与大体标本的平均测量值之间无差异。然而，在矢状面，内侧和外侧胫骨平台的解剖标本分别为外侧 X 线片测量值的 90%和 80%。
这项尸体研究首次提出了胫骨平台骨软骨同种异体移植物的尺寸确定算法。根据结果，前后位 X 线片可以可靠地测量内侧和外侧胫骨平台的宽度，无需任何校正。另一方面，内侧和外侧胫骨平台的平均形态长度分别为 X 线片测量长度的 90%和 80%。如果不进行校正，这将导致植入过大的移植物，可能导致早期失败。
