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Review
. 2023 Feb;49(1):69-74.
doi: 10.1007/s00068-022-02043-5. Epub 2022 Jul 13.

The symmetry of the left and right tibial plateau: a comparison of 200 tibial plateaus

Nynke van der Gaast  1 , Hans Dunning  2 , Jellina M Huitema  3 , Andrew Waters  4 , Ruurd L Jaarsma  4 , Job N Doornberg  5 , Michael J R Edwards  3 , Sebastiaan A W van de Groes  6 , Erik Hermans  3
Affiliations
Review

The symmetry of the left and right tibial plateau: a comparison of 200 tibial plateaus

Nynke van der Gaast et al. Eur J Trauma Emerg Surg. 2023 Feb.

Abstract

Purpose: This study aims to investigate the symmetry of the left and right tibial plateau in young healthy individuals to determine whether left-right mirroring can be reliably used to optimize preoperative 3D virtual planning for patients with tibial plateau fractures.

Methods: One hundred healthy subjects, without previous knee surgery, severe knee trauma, or signs of osteoarthritis were included for a previous dynamic imaging study of the knee. The subjects underwent a CT scan, scanning the left and right knee with a slice thickness of 0.8 mm. 3D surface models of the femur, patella, and tibia were created using a convolutional neural network. The 3D models of the left and right tibias were exported to MATLAB © and the tibias were mirrored. The mirrored tibias were superimposed on the contralateral tibia using a coherent point drift surface matching algorithm. Correspondence points on both surfaces were established, the mean root squared distance was calculated and visualized in a boxplot and heatmaps.

Results: The overall mean difference between correspondence points on the left and right tibial plateau is 0.6276 ± 0.0343 mm. The greatest differences between correspondence points were seen around two specific surfaces on the outside of the tibial plateau; where the distal tibia was cut 15 mm below the tibial plateau and around the tibiofibular joint.

Conclusions: The differences between the left and right tibial plateau are small and therefore, we can be confident that the mirrored contralateral, unfractured, tibial plateau can be used as a template for 3D virtual preoperative planning for young patients without previous damage to the knee.

Keywords: 3D virtual planning; Surgical planning; Symmetry; Tibial plateau; Tibial plateau fractures.

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Conflict of interest statement

Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members.

Figures

Fig. 1
Fig. 1
Overview of methods. a Left tibia (red) is mirrored along the sagittal plane (blue). The surface of the mirrored left tibia is superimposed with the surface of the right tibia (black). b Superimposed, mirrored left tibia and right tibia are cut 15 mm below the tibial plateau in an axial plane (blue). c Resulting proximal parts of both tibias are again superimposed to prevent malposition due to distal surface points. d Correspondence points are established (red and black) and the Euclidean distance between these points is calculated
Fig. 2
Fig. 2
Boxplot of the Euclidean distance of all correspondence points on the left and right tibia
Fig. 3
Fig. 3
Overview of artefacts: a Heatmaps were used to illustrate artifacts at a cut-off edges of the tibia and b tibiofibular joint
Fig. 4
Fig. 4
Heatmap investigating the largest distance between correspondence points observed in one subject’s tibial plateau (posterior view)
See this image and copyright information in PMC

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