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

Eur J Trauma Emerg Surg. 2023 Feb;49(1):69-74. doi: 10.1007/s00068-022-02043-5. Epub 2022 Jul 13.

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.

Publication types

  • Review

MeSH terms

  • Femur
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery
  • Patella
  • Tibia* / diagnostic imaging
  • Tibial Fractures* / diagnostic imaging
  • Tibial Fractures* / surgery