Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA.
Keck School of Medicine of USC, Los Angeles, CA.
J Orthop Trauma. 2019 Apr;33(4):180-184. doi: 10.1097/BOT.0000000000001412.
We hypothesized that a constant radiographic relationship exists between the lateral tibial and femoral condyles and that no side-to-side variation exists.
We reviewed anteroposterior x-rays of 217 uninjured adults ages 18-65, Included 109 unilateral and 108 bilateral radiographs with no or minimal osteoarthrosis (Kellgren-Lawrence grades 0-1). The perpendicular distance between the lateral-most margins of the tibial plateau articular surface (A) and the lateral femoral epicondyle (B) and the lateral femoral condyle articular surface (C) was measured in millimeters (mm). Medial and lateral measurements to point (A) were recorded as (-) and (+), respectively. First, the average of measured distances in all unilateral knees and randomly selected either right or left knees from the bilateral group (n = 217) was calculated. Comparison was made between both sexes. Next, A-B and A-C distances were compared between right and left knees in the bilateral group (n = 108) to find any significant difference (2-tailed t test, alpha = 0.05).
The average A-B distance was 0.60 ± 2.40 mm (-4.82 to +6.49 mm). The mean A-C distance was -3.96 ± 2.07 mm (-8.51 to +3.98 mm). No significant difference was found between A-B and A-C distances between males (0.40 ± 2.62 mm and -3.91 ± 2.05 mm) and females (0.70 ± 2.28 mm and -3.99 ± 2.09 mm). Similarly, no significant difference was found between A-B and A-C distances between right (1.08 ± 2.31 mm and -3.90 ± 1.73 mm) and left knees (0.90 ± 2.38 mm and -4.31 ± 1.7 mm). Concordance coefficient for interobserver and intraobserver reliability showed substantial agreement.
In conclusion, this study provided a "normal" range for the relationship of the proximal lateral tibial plateau relative to the lateral femoral condyle. The lateral femoral epicondyle is generally aligned with the lateral tibial articular margin. The relationship between the lateral tibial plateau, lateral femoral epicondylar surface, and lateral femoral articular surface is constant from side to side. This technique is reproducible in the setting of fracture, and templating off of the contralateral uninjured knee may be beneficial in tibial plateau fracture surgery.
我们假设外侧胫骨和股骨髁之间存在恒定的影像学关系，并且不存在左右侧的差异。
我们回顾了 217 名 18-65 岁未受伤成年人的前后位 X 线片，包括 109 例单侧和 108 例双侧 X 线片，均无或仅有轻微骨关节炎（Kellgren-Lawrence 分级 0-1）。测量外侧胫骨平台关节面（A）和外侧股骨髁（B）以及外侧股骨髁关节面（C）最外侧边缘之间的垂直距离，以毫米（mm）为单位。内侧和外侧到点（A）的测量值分别记录为（-）和（+）。首先，计算所有单侧膝关节和双侧组中随机选择的右或左膝关节（n=217）的测量距离平均值。比较了两性之间的差异。接下来，比较双侧组（n=108）中右膝和左膝的 A-B 和 A-C 距离，以发现任何显著差异（双侧 t 检验，α=0.05）。
A-B 距离的平均值为 0.60±2.40mm（-4.82 至+6.49mm）。A-C 距离的平均值为-3.96±2.07mm（-8.51 至+3.98mm）。男性（0.40±2.62mm 和-3.91±2.05mm）和女性（0.70±2.28mm 和-3.99±2.09mm）之间的 A-B 和 A-C 距离没有显著差异。同样，右膝（1.08±2.31mm 和-3.90±1.73mm）和左膝（0.90±2.38mm 和-4.31±1.7mm）之间的 A-B 和 A-C 距离也没有显著差异。观察者间和观察者内可靠性的一致性系数显示出高度一致性。
总之，本研究提供了外侧胫骨平台相对于外侧股骨髁关系的“正常”范围。外侧股骨髁通常与外侧胫骨关节缘对齐。从一侧到另一侧，外侧胫骨平台、外侧股骨髁表面和外侧股骨关节表面之间的关系是恒定的。在骨折的情况下，这种技术具有可重复性，并且可以从对侧未受伤的膝关节模板化，这可能对胫骨平台骨折手术有益。
