A landmark-based 3D analysis reveals a narrower tibial plateau and patella in trochlear dysplastic knees
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The trochlear dysplastic femur has a specific morphotype previously characterised by not only dysplastic features of the trochlea but also by specific features of the notch and posterior femur. In this study the morphology of the tibia and patella was investigated to gain further insight in the complete geometrical complexity of the trochlear dysplastic knee.
Arthro-CT scan-based 3D models of 20 trochlear dysplastic and 20 normal knees were uniformly scaled and landmarks and landmark-based reference planes were created to quantify a series of morphometric characteristics of the tibia and patella.
In the mediolateral direction, the 3D-analysis revealed a 3% smaller medial tibial plateau (30.4 ± 1.6 mm vs 31.5 ± 1.6 mm), a 3% smaller overall width of the tibial plateau (73.6 ± 2.0 mm vs 75.7 ± 2.0 mm), a 16% smaller medial facet (17.3 ± 2.2 mm vs 20.1 ± 1.3 mm) and a 4% smaller overall width of the patella (41.7 ± 2.5 mm vs 43.4 ± 2.3 mm) in trochlear dysplastic knees. In the anteroposterior direction, the lateral tibial plateau of trochlear dysplastic knees was 5% larger (37.2 ± 2.3 mm vs 35.5 ± 3.1 mm). A correlation test between the width of the femur and the width of the tibia revealed that trochlear dysplastic knees show less correspondence between the femur and tibia compared to normal knees.
Significant differences in the morphology of the tibial plateau and patella were detected between trochlear dysplastic and normal knees. Both in the trochlear dysplastic tibial plateau and patella a narrower medial compartment leads to a significant smaller overall mediolateral width. These findings are important for the understanding of knee biomechanics and the design of total knee arthroplasty components.
Level of evidence
KeywordsPatellofemoral joint Tibia Patella Trochlear dysplasia Morphology Three dimensional Measurements
Patella anterior point
Patella inferior point
Patella lateral point
Patella medial point
Patella odd point inferior
Patella odd point superior
Patella posterior point
Patella ridge point inferior
Patella ridge point superior
Patella superior point
Total knee arthroplasty
Tibial lateral intercondylar eminence
Tibial lateral plateau anterior
Tibial lateral plateau posterior
Tibial medial intercondylareminence
Tibial medial plateau anterior
Tibial medial plateau posterior
Tibial plateau anterior
Tibial plateau lateral
Tibial plateau medial
Tibial tuberosity-trochlear groove
WP designed the study, acquired and analysed the data, interpreted the results, wrote the first draft of the manuscript and revised it based on comments of other authors; PV and AVH contributed substantially to the conception and design of the work, the analysis and interpretation of the data; SVDW contributed substantially to the data acquisition and graphic design. All authors revised the draft manuscript for important intellectual content, approved the final version of the manuscript to be published, and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
The authors received no specific funding for this work.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
This study was in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments.
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