A Radiographic Sizing Algorithm for Tibial Plateau Osteochondral Allografts

Abstract

Objective Tibial plateau osteochondral allograft transplantation is a promising treatment for symptomatic chondral damage of the proximal tibia due to a variety of etiologies. The purpose of this investigation is to develop an accurate and reproducible algorithm for sizing tibial plateau allografts based on recipient radiographs. Design A cadaveric study was performed in which radiographs of 10 fresh frozen cadaveric knees were compared to measured digital photographs of the disarticulated specimens. By comparing the average distance between standard anatomical landmarks on the radiographs to the gross specimens, a correlation factor was calculated that could be applied to recipient radiograph measurements for more accurate sizing of tibial plateau allografts. Results In the coronal plane there were no differences between the mean radiographic and mean morphologic measurements of either the medial or lateral tibial plateau. However, in the sagittal plane the anatomic specimens of the medial and lateral plateau were 90% and 80%, respectively, of the measurements made from the lateral radiograph. Conclusions This cadaveric investigation is the first to propose a sizing algorithm for tibial plateau osteochondral allografts. Based on the results, an anteroposterior radiograph can reliably measure the width of both the medial and lateral tibial plateau without any correction needed. The average morphological lengths of the medial and lateral tibial plateau, on the other hand, were found to be 90% and 80%, respectively, of the radiographically measured lengths. Without correction, this would lead to the implantation of oversized grafts that may contribute to early failure.

Comparison of meniscal allograft transplantation techniques using a preclinical canine model

“…In addition, this technique addresses key sizing and fixation factors that have been reported to directly affect meniscal function, chondroprotection, and transplant survival. [45][46][47] Finally, by replacing the damaged tibial plateau in conjunction with MAT, whole-joint pathology is more completely addressed, which in Importantly, significant improvements in lameness scoring, functional kinematics, and knee effusion after MAT were noted for all three treatment types, reflecting the reported benefits of addressing meniscus deficiency with meniscus allograft transplantation reported clinically and validating the preclinical canine model used. 14 These findings accentuate the significant differences noted with regards to pain, CROM, diagnostic imaging, gross, and histologic assessments as well as cell viability results for the fresh menisco-tibial MAT treatment.…”

“…In addition, this technique addresses key sizing and fixation factors that have been reported to directly affect meniscal function, chondroprotection, and transplant survival. [45][46][47] Finally assessments, which is thought to be related to the less invasive nature of meniscus-only techniques. However, at the 6-month study endpoint when healing and graft integration had occurred, the menisco-tibial MAT group was associated with superior outcomes, most likely due to preserved meniscal integrity and function, treatment of tibial articular cartilage pathology, and avoidance of shrinkage, extrusion, failure, or progression of joint pathology.…”

“…Fresh meniscal‐osteochondral allograft transplantation with menisco‐tibial ligament preservation allowed for resurfacing of affected tibial cartilage with intact hyaline cartilage. In addition, this technique addresses key sizing and fixation factors that have been reported to directly affect meniscal function, chondroprotection, and transplant survival 45‐47 . Finally, by replacing the damaged tibial plateau in conjunction with MAT, whole‐joint pathology is more completely addressed, which in turn mitigates the progression of cartilage damage, degradation and loss, and the associated failure of MAT.…”

Tibial Spine Height Measured by Radiograph Is a Risk Factor for Non-Contact Anterior Cruciate Ligament Injury in Males: A Retrospective Case-Control Study

“…All the subjects underwent the radiograph examination in a standing position with the knee at full extension and close to the detector, with the patella facing forward, in order to eliminate the influence of malrotation and flexion of the knee joint on the measuring results. The X-ray bulb was taken at a caudal inclination of 10–15° to produce a complete intercondylar spine pattern with the anterior and posterior edges of the tibial plateau overlapped [ 25 ]. The scanning parameters were as follows: tube voltage, 60 kV; tube current, 250 mA, 16 ms; and a film distance of 120 cm.…”

Tibial Spine Height Measured by Radiograph is A Risk Factor for Non-Contact Anterior Cruciate Ligament Injury in Males: A Retrospective Case-Control Study

“…All the subjects underwent the radiograph examination in a standing position with the knee at full extension and close to the detector, and with the patella facing forward, in order to eliminate the in uence of the malrotation and exion of the knee joint on the measuring results. The X-ray bulb was taken at a caudal inclination of 10-15° to produce a complete intercondylar spine pattern with the anterior and posterior edges of the tibial plateau overlapped [25]. The scanning parameters were as follows: tube voltage, 60 kV; tube current, 250 mA, 16 ms; and a lm distance of 120 cm.…”