Objective: To evaluate the prevalence and magnitude of sagittal plane deformity in bicondylar tibial plateau fractures.
Design: Retrospective radiographic review.
Setting: Two Level I trauma centers.
Main Outcome Measurement: Sagittal inclination of the medial and lateral plateau measured in relation to the longitudinal axis of the tibia using computed tomographic reconstruction images.
Patients: Seventy-four patients (mean age, 49 years; range, 16-82 years; 64% male) with acute bicondylar tibial plateau fractures (Orthopaedic Trauma Association 41C, Schatzker VI) treated from October 2006 to July 2009.
Results: The average sagittal plane angulation of the lateral plateau was 9.8° posteriorly (range, 17° anteriorly to 37° posteriorly). The medial plateau was angulated 4.1° posteriorly on average (range, 16° anteriorly to 31° posteriorly). Forty-two lateral plateaus were angulated more than 5° from the "normal" anatomic slope (defined as 5° of posterior tibial slope). Of these, 76% were angulated posteriorly. Forty-three (58%) of the medial plateaus were angulated greater than 5° from normal, of which only 47% were inclined posteriorly (P = 0.019 compared with lateral plateaus). In 68% of patients, the difference between medial and lateral plateaus was greater than 5°; the average intercondylar slope difference was 9° (range, 0°-31°; P < 0.001). Spanning external fixation did not affect the slope of either the medial or lateral tibial plateau. Intraobserver and interobserver correlations were high for both the medial and lateral plateaus (r > 0.81, P < 0.01).
Conclusions: Considerable sagittal plane deformity exists in the majority of bicondylar tibial plateau fractures. The lateral plateau has a higher propensity for sagittal angulation and tends to have increased posterior slope. Most patients have a substantial difference between the lateral and medial plateau slopes. The identification of this deformity allows for accurate preoperative planning and specific reduction maneuvers to restore anatomic alignment.
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http://dx.doi.org/10.1097/BOT.0b013e318200971d | DOI Listing |
Arch Bone Jt Surg
January 2024
Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Objectives: Previous studies of the association between tibial slope and meniscal tear have led to contradictory results. In this regard, the present study aimed to examine the effect of medial tibial plateau slope on the incidence of isolated medial meniscal tear.
Methods: This study was performed on 75 patients with a posterior horn medial meniscal tear and 150 matched control subjects.
J Orthop
August 2025
Department of Orthopaedic Surgery, Oita University Hospital, Japan.
Background: This study examines the relationship between the anterior offset of the tibial intramedullary nail (TIN) entry point and the tibial shaft axis to enhance the fit and alignment of TINs, using transparent 3D-CT in an accurate lateral view to minimize rotational artifacts.
Methods: Data were collected from 100 adult patients undergoing tibial CT scans. Measurements included the anterior offset from the tibial axis to the entry point, tibial tubercle offset, tibial plateau length, posterior slope, tibial length, isthmus diameter, and the isthmus-to-tibial length ratio.
Zhongguo Gu Shang
January 2025
Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China.
Tibial plateau fracture is a fracture involving the proximal articular surface of the tibia, and its injury mechanism is complex, the fracture morphology is different, and it is often accompanied by different degrees of soft tissue injury, which is difficult to diagnose and treat. In recent years, the research hotspot has focused on solving the reduction and fixation of the posterior lateral column of the tibial plateau, because it has been clinically found that the residual sagittal plane after tibial plateau fracture is insufficient reduction or loss of reduction leads to knee joint dysfunction. The posterior inclination angle of the tibial plateau is an important parameter to describe the sagittal alignment of the tibia.
View Article and Find Full Text PDFZhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
January 2025
The Third Orthopedic Department, the First Affiliated Hospital of Harbin Medical University, Harbin Heilongjiang, 150001, P. R. China.
Objective: To measure and analyze the relationships among the posterior tibial slope (PTS), meniscal slope (MS), and meniscus posterior horn thickness (MPHT) of the medial and lateral tibial plateau in healthy people and patients with anteromedial osteoarthritis (AMOA) in Heilongjiang province, so as to provide reference basis for appropriate tibial osteotomy and prosthesis placement angles in knee joint surgeries.
Methods: A retrospective collection of imaging data from knee joint MRI examinations conducted prior to AMOA for various reasons was performed. A total of 103 healthy individuals (healthy group) and 30 AMOA patients (AMOA group) were included.
Orthop Surg
January 2025
Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, Beijing, China.
Objective: Robotic-assisted total knee arthroplasty (TKA) is a novel orthopedic technique. The workflow of robotic-assisted TKA is quite different from that of traditional manual TKA and may result incompletely different resection parameters. Understanding these parameters may help surgeons better perform robotic-assisted TKA.
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