J Korean Orthop Assoc.  2007 Jun;42(3):340-344. 10.4055/jkoa.2007.42.3.340.

The Wear Pattern of Articular Cartilage of Medial Tibial Plateau with or without Functional ACL in Patients with Degenerative Osteoarthritis of the Knee

• Cho YJ
• Choi CH
• Kim JH
• Chung HK

• KMID: 2186558
• DOI: http://doi.org/10.4055/jkoa.2007.42.3.340

Abstract

PURPOSE: This study examined the wear pattern of the articular cartilage of the medial tibial plateau with or without a functional ACL in patients with degenerative osteoarthritis of the knee.
MATERIALS AND METHODS
Between July 2003 and May 2004, 71 cases (52 patients) of total knee arthroplasty due to degenerative osteoarthritis of the knee were enrolled in this study. The intraoperative evaluations such as a test for the functional status of the ACL and the wear pattern of medial tibial plateau were performed, and the associations with the physical examinations such as, range of motion (ROM), Lachman test and pivot shift test, and tibio-femoral angle (TFA), were analyzed.
RESULTS
There were 43 cases with a functional ACL, and the wear pattern of the medial tibial plateau was differentiated as anteromedial and central in 8 cases (18.6%), central in 30 cases (69.8%), and central and posteromedial in 5 cases (11.6%). There were 28 cases with a non- functional ACL and the wear pattern of the medial tibial plateau was differentiated as anteromedial and central in 1 case (3.6%), central in 2 cases (7.2%), and central and posteromedial in 25 cases (89.2%). In the group with the non-functional ACL, the most prevalent wear pattern was central and posteromedial (p<0.001).
CONCLUSION
In patients with degenerative osteoarthritis of the knee without a functional ACL, the wear pattern of the articular cartilage of the medial tibial plateau was more posteromedially than patients with a functional ACL.

Keyword

ACL; Medial tibial plateau; Articular cartilage; Wear pattern; Degenerative osteoarthritis; Total knee arthroplasty

MeSH Terms

Arthroplasty
Cartilage, Articular*
Humans
Knee*
Osteoarthritis*
Physical Examination
Range of Motion, Articular

Figure

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  Fig. 1 Image showing the anteromedial and central wear pattern of the medial tibial plateau, relatively well preserved anterior cruciate ligament and lateral tibiofemoral compartment. There is deep erosion on the anterior part of the medial tibial plateau. The ROM of the knee is 135° and the TFA is 2.8° of varus.

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  Fig. 2 Image showing the central wear pattern of the medial tibial plateau, a relatively well preserved anterior cruciate ligament and lateral tibiofemoral compartment. There is deep erosion on the central part of the medial tibial plateau. The ROM of the knee is 135° and the TFA is 3° of varus.

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  Fig. 3 Image showing the central and posteromedial wear pattern of the medial tibial plateau, torn non-functional anterior cruciate ligament and osteoarthritic change in the lateral tibiofemoral compartment. There is deep erosion on the posteromedial part of the medial tibial plateau. The ROM of the knee is 110° and the TFA is 7° of varus.

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  Fig. 4 The association between the ACL status and the wear pattern of the medial tibial plateau of degenerative osteoarthritis of the knee. When there was a functional ACL, the most common wear pattern of the medial tibial plateau of the knee was central (69.8%). When there was a non-functional ACL, the most common wear pattern was central and posteromedial (89.2%). F, functional ACL group; N, non-functional ACL group; AM, anteromedial and central; C, central; PM, central and posteromedial.

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