Increased posterior tibial slope leads to altered pressure distribution in the lateral tibial plateau-A biomechanical in-vitro study.

IF 3.3 2区 医学 Q1 ORTHOPEDICS
Kai Hoffeld, Luis Göker, David Grevenstein, Jan Philipp Hockmann, Benjamin Rosswinkel, Peer Eysel, Johannes Oppermann
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引用次数: 0

Abstract

Purpose: The aim of this study is to investigate the impact of increased posterior tibial slope (PTS) on pressure distribution in the medial and lateral tibial plateau. The focus is on compartment-specific effects and potential correlations with cartilage damage, due to altered anterior tibial translation caused by increased PTS.

Method: Ten freshly frozen knee specimens were prepared and subjected to biomechanical testing. PTS was modified by inserting 5°, 10°, 15° and 20° polylactic acid wedges into osteotomy gaps. Pressure distribution was measured using Tekscan's Pressure Mapping Sensor 5040™ beneath the menisci at varying PTS angles. The kinetic data were tracked using the Optotrak Certus® system. Statistical analyses were employed to evaluate the pressure shifts and their significance.

Results: The study revealed that increased PTS significantly shifted the pressure point anteriorly on the lateral tibial plateau, while no significant changes were observed on the medial plateau. The analysis of tibial translation showed a corresponding rise in anterior translation with increasing PTS, especially at higher angles.

Conclusion: Increased PTS, particularly above 10°, induces significant anterior translation and altered pressure distribution, primarily affecting the lateral tibial plateau. These findings support the hypothesis that elevated PTS contributes to biomechanical stresses in the knee, potentially increasing the risk of lateral compartment cartilage degeneration. These results highlight the importance of considering PTS in clinical assessments and interventions aimed at optimizing knee joint health.

Level of evidence: Level IV.

胫骨后坡增加导致胫骨外侧平台压力分布改变——体外生物力学研究。
目的:本研究的目的是探讨胫骨后坡(PTS)增加对胫骨平台内侧和外侧压力分布的影响。重点是室特异性效应和软骨损伤的潜在相关性,这是由于PTS升高引起的胫骨前平移的改变。方法:制备新鲜冷冻膝关节标本10例,进行生物力学试验。将5°、10°、15°和20°聚乳酸楔置入截骨间隙,改良PTS。使用Tekscan的压力映射传感器5040™测量半月板下不同PTS角度的压力分布。使用Optotrak Certus®系统跟踪动力学数据。采用统计学方法评价压力变化及其显著性。结果:研究显示,PTS升高使胫骨外侧平台的压力点明显前移,而内侧平台的压力点无明显变化。胫骨平移分析显示,随着PTS的增加,尤其是在较高角度时,前平移相应增加。结论:PTS升高,尤其是超过10°时,会引起明显的前平移和压力分布改变,主要影响胫骨外侧平台。这些发现支持了这样的假设,即升高的PTS会增加膝关节的生物力学应力,潜在地增加外侧间室软骨退变的风险。这些结果强调了在临床评估和旨在优化膝关节健康的干预措施中考虑PTS的重要性。证据等级:四级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.10
自引率
18.40%
发文量
418
审稿时长
2 months
期刊介绍: Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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