Comparison between three-dimensional CT and conventional radiography in proximal tibia morphology

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Abstract

To provide morphological parameters of the normal tibial plateau by using three-dimensional (3D) CT and conventional radiography.

We performed morphological measurements of tibial plateau on 157 consecutive adults using radiographic and 3D computed tomography (CT). Gender differences as well as differences in measurement techniques were statistically compared. Intraclass correlation coefficient (ICC) was used to evaluate intra- and interobserver reproducibility.

The mediolateral dimensions, anteroposterior dimensions of tibial plateau showed significant differences according to gender, but no statistical differences were observed in coronal tibial slope as well as in posterior slope. There were significant differences in all parameters between 2 measurement techniques. 3D-CT measurements had a higher ICC in all parameters than that in the radiographs.

This study confirmed that 3D morphological measurements of tibial plateau have more reproducibility than radiographs. Our data will be helpful for tibial component design and placement.

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Most cited references 40

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The geometry of the tibial plateau and its influence on the biomechanics of the tibiofemoral joint.

J L Slauterbeck, Bruce Beynnon, N Chandrashekar … (2008)

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.

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Shallow medial tibial plateau and steep medial and lateral tibial slopes: new risk factors for anterior cruciate ligament injuries.

J L Slauterbeck, Bruce Beynnon, N Chandrashekar … (2009)

The geometry of the tibial plateau has been largely ignored as a source of possible risk factors for anterior cruciate ligament injury. Discovering the anterior cruciate ligament injury risk factors associated with the tibial plateau may lead to delineation of the existing sex-based disparity in anterior cruciate ligament injuries and help develop strategies for the prevention of anterior cruciate ligament injuries regardless of gender. Individuals with a shallower medial tibial depth of concavity, while having increased posteriorly directed slope of their tibial plateau, are at increased risk of suffering an anterior cruciate ligament injury compared with those with decreased posterior slope and increased medial tibial depth. Furthermore, these relationships are different between men and women. Case-control study (prevalence); Level of evidence, 3. The medial, lateral, and coronal tibial plateau slopes as well as the medial tibial depth of concavity in 55 uninjured controls (33 women and 22 men) and 49 anterior cruciate ligament-injured cases (27 women and 22 men) were measured using magnetic resonance images. First, a preliminary t test was performed to establish any existing differences between groups. Next, a logistic regression model was developed to determine the probability of anterior cruciate ligament injury in an individual based on the measured covariates. The female anterior cruciate ligament-injured cases had increased lateral tibial slope (P = .03) and shallower medial tibial depth (P = .0003) compared with the uninjured controls, while male cases had increased lateral and medial tibial slope (P = .02) and shallower medial tibial depth (P = .0004) compared with controls. The logistic regression analysis and odds ratio estimates showed that medial tibial depth is an important risk factor (odds ratio = 3.03 per 1 mm decrease in its value), followed by lateral tibial slope (odds ratio = 1.17 per 1 degrees increase in its value) in all participants. The medial tibial slope (odds ratio = 1.18 per 1 degrees increase in its value) was a risk factor only in men. A combination of increased posterior-directed tibial plateau slope and shallow medial tibial plateau depth could be a major risk factor in anterior cruciate ligament injury susceptibility regardless of gender. Different injury risk models may be needed for men and women as other key risk factors are identified.

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Novel measurement technique of the tibial slope on conventional MRI.

Robert Hudek, Silvia Schmutz, Felix Regenfelder … (2009)

The posterior inclination of the tibial plateau, which is referred to as posterior tibial slope, is determined routinely on lateral radiographs. However, radiographically, it is not always possible to reliably recognize the lateral plateau, making a separate assessment of the medial and lateral plateaus difficult. We propose a technique to measure the plateaus separately by defining a tibial longitudinal axis on a conventional MRI. The medial plateau posterior tibial slope obtained from radiographs was compared with MR images in 100 consecutive patients with knee pain when ligament or meniscal injury was assumed. The posterior tibial slope on MRI correlated with those on radiographs. The mean posterior tibial slope was 3.4 degrees smaller on MRI compared with radiographs (4.8 degrees +/- 2.4 degrees versus 8.2 degrees +/- 2.8 degrees , respectively). The reproducibility was slightly better on radiographs than MRI (+/- 0.9 degrees versus +/- 1.4 degrees ). Twenty-one of the 100 cases had more than a 5 degrees difference (range, -8.7 degrees to 8.9 degrees ) between the medial and lateral plateaus. The proposed technique allows measurement of the posterior tibial slope of the medial and lateral plateaus on a standard knee MRI. By using this novel measurement technique, a reliable assessment of the medial and lateral tibial plateaus is possible.

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Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: July 2018

Publication date (Electronic): 27 July 2018

Volume: 97

Issue: 30

Electronic Location Identifier: e11632

Affiliations

Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, Shanhai, China.

Author notes

[∗ ]Correspondence: Yanxi Chen, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China (e-mail: cyxtongji@ 123456126.com ).

Article

Publisher ID: MD-D-17-01916 Accession ID: 11632

DOI: 10.1097/MD.0000000000011632

PMC ID: 6078714

PubMed ID: 30045306

SO-VID: 88abd45c-bbda-43f1-8838-d9e1924319cf

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This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

History

Date received : 1 April 2017

Date accepted : 30 June 2018

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Keywords: anthropometry,computed tomography,imaging,three-dimensional,tibia,tomography,x-ray computed

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Keywords: anthropometry, computed tomography, imaging, three-dimensional, tibia, tomography, x-ray computed

Comparison between three-dimensional CT and conventional radiography in proximal tibia morphology

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Most cited references 40

The geometry of the tibial plateau and its influence on the biomechanics of the tibiofemoral joint.

Shallow medial tibial plateau and steep medial and lateral tibial slopes: new risk factors for anterior cruciate ligament injuries.

Novel measurement technique of the tibial slope on conventional MRI.

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