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

Yong Jin Cho; Choong-Hyeok Choi; Jong Heon Kim; Hyun Kee Chung

doi:10.4055/jkoa.2007.42.3.340

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Cho, Choi, Kim, and Chung: The Wear Pattern of Articular Cartilage of Medial Tibial Plateau with or without Functional ACL in Patients with Degenerative Osteoarthritis of the Knee

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(3): 340-344.

Published online: 30 June 2007

DOI: https://doi.org/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

Yong Jin Cho, M.D., Choong-Hyeok Choi, M.D.^*, Jong Heon Kim, M.D.^*, Hyun Kee Chung, M.D.^†

Department of Orthopedic Surgery, Madi Hospital, Seoul, Korea.

^*Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Korea.

^†Cheil Orthopedic Hospital, Seoul, Korea.

Address reprint requests to Choong-Hyeok Choi, M.D. Department of Orthopaedic Surgery, Hanyang University Hospital, 17, Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea. Tel: +82.2-2290-8483, 8485, Fax: +82.2-2299-3774, chhchoi@hanyang.ac.kr

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 nonfunctional 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.

Keywords: ACL, Medial tibial plateau, Articular cartilage, Wear pattern, Degenerative osteoarthritis, Total knee arthroplasty

Figures and Tables

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.

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.

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.

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.

References

1. Ahlbäck S. Osteoarthritis of the knee. A radiographic investigation. Acta Radiol (Stockh). 1968. 277:Suppl. 7–72.

2. Freeman MAR. Apley AG, editor. The pathogenesis of primary osteoarthrosis: an hypothesis. Modern trends in orthopaedics. 1972. Vol 6. London: Butterworths;40.

3. Freeman MAR, Meachim G. Freeman MAR, editor. Aging and degeneration. Adult articular cartilage. 1979. 2nd ed. Tunbridge Wells: England: Pitman Medical;487.

4. Harrington IJ. Static and dynamic loading patterns in knee joints with deformities. J Bone Joint Surg Am. 1983. 65:247–259.

5. Hernborg JS, Nilsson BE. The natural course of untreated osteoarthritis of the knee. Clin Orthop Relat Res. 1977. 123:130–137.

6. Hill CL, Seo GS, Gale D, Totterman S, Gale ME, Felson DT. Cruciate ligament integrity in osteoarthritis of the knee. Arthritis Rheum. 2005. 52:794–799.

7. Iwaki H, Pinskerova V, Freeman M. Tibiofemoral movement 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee. J Bone Joint Surg Br. 2000. 82:1189–1195.

8. Morrison JB. The mechanics of the knee joint in relation to normal walking. J Biomech. 1970. 3:51–61.

9. Schipplein OD, Andriacchi TP. Interaction between active and passive knee stabilizers during level walking. J Orthop Res. 1991. 9:113–119.

10. White SH, Ludkowski PF, Goodfellow JW. Anteromedial osteoarthritis of the knee. J Bone Joint Surg Br. 1991. 73:582–586.

11. Zuppinger H. Die aktive flexion im unbelasteten kniegelenk. 1904. Wiesbaden: Bergmann;703.

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