Assessment of morphological differences of the proximal tibia in healthy knees: analysis of the 3-dimensional mathematical model.

BACKGROUND

High tibial osteotomy and many orthopedic surgical procedures around the knee joint requires precise preoperative planning. In-depth knowledge of the tibial plateau morphology is necessary to limit intraoperative complications like lateral hinge fracture. No studies were exploring the differences in proximal tibia surface geometry, in regards to gender and laterality, using a mathematical model. The aim of our study was to assess morphological differences in healthy knees using a three-dimensional mathematical model.

METHODS

Eighty-seven computed tomography examinations collected from 52 patients were selected for the study. The inclusion criteria were: age between 20 and 40 years, knee joint without visible deformities, no history of significant trauma to index knee, no history of systemic and chronic disorders. The average age of the included patients was 32.5±8.9 years old. For the calculation and comparisons, 45 right knee joints (18 females and 27 males) and 42 left knee joints (17 females and 25 males) were used.

RESULTS

The male tibial plateau was much larger than the female one, for the right (P=0.001) and left knees (P=0.001). Male knees showed much bigger variability in two-dimensional tibial plateau dimensions especially for the left knees (P=0.001), and there was also a marked difference in variability between sides in males. Three-dimensional variability was significant for medial condyles for both genders. Male knees had a statistically bigger (P=0.04) tibial plateau surface area for all measured condyles.

CONCLUSIONS

The proximal tibial plateau showed in the designed mathematical models high variability in the two-dimensional and three-dimensional analysis. The males' knees presented great variability between sides and condyles. This finding must be considered during preoperative planning.