Determination Of The Offset Of Tibial Plateau In Relation To The Tibial Shaft In Indian Population.

[摘要] Tibial plateau fractures are complex injuries of the knee. The tibial plateau is one of the most critical load-bearingareas in the human body. Early detection and appropriate treatment of these fractures are essential in minimizing patient'sdisability in range of movement, stability and reducing the risk of documented complications. To determine the relation ofthe tibial plateau offset in relation to the tibial shaft in a normal Indian population using 124 slice computed tomography.This Cross-sectional Study was conducted in year December-2019- June 2021 At PSG Institute Of Medical Sciences AndResearch Coimbatore. In the CT images of the tibia, using Axial cuts, the axis of the medullary cavity is determined. At adistance of seven cm from the tibial plateau, the center of the cross-section of the tibia is marked. And a similar point istaken at a distance of eleven cm from the tibial plateau. The line joining these two points is extended proximally and distallyrepresents the anatomic axis of the tibial shaft. Correlation analysis (the Pearson correlation coefficient) was performed todetermine the associations between the dimension of the tibial plateau and the offset of the tibial shaft from the tibialplateau, P value <0.05 was considered as statistically significant. The Mean Lateral Medial Dimension of the Tibial Plateauwas found to be 7.3±0.04. this was found to be similar across the age categories(p=0.484) but was significantly lower infemales in comparison to the male counterparts (6.78 ± 0.05 and 7.55 ± 0.04 respectively) (p<0.001). The Mean PosteriorAnterior Dimension of the Tibial Plateau was found to be 5.11 ±0.03. this was found to be similar across the age categories(p=0.308) but was significantly lower in females in comparison to the male counterparts (4.76 ± 0.04 and 5.27 ± 0.03respectively) (p<0.001). The Mean Lateral Medial Distance of the Tibial Plateau was found to be 3.89 ± 0.03. this was foundto be similar across the age categories(p=0.189) but was significantly lower in females in comparison to the malecounterparts (3.46 ± 0.04 and 3.89 ± 0.03 respectively) (p<0.001). The Mean Posterior Anterior Distance of the TibialPlateau was found to be 3.22 ±0.03. This was found to be significantly lower in extreme groups (p=0.03) across the agecategories and also was significantly lower in females in comparison to the male counterparts (2.97 ± 0.05 and 3.33 ± 0.04respectively) (p<0.001). The Mean Lateral Medial Offset of the Tibial Plateau was found to be 0.10 ± 0.02 towards the Medialdirection. This was found to be pointing towards the medial direction in all age categories with offset significantly higher inmore than 70 years age group (p = 0.028) but was similar in females and males (p= 0.382) towards the medial direction.The Mean Posterior Anterior Offset of the Tibial Plateau was found to be 0.67 ± 0.03 towards the Anterior direction. Thiswas found to be pointing towards the Anterior direction in all age categories with offset significantly lower in more than 70years age group (p<0.001) but was similar in females and males (p= 0.114) towards the Anterior direction. The Mean Offsetof the tibial shaft from the tibial plateau was found to be 0.75 ± 025. this was found to be significantly lower in the morethan 70 years category (p= 0.003) and was significantly lower in females in comparison to the male counterparts (0.65±0.04 and 0.79 ± 0.03 respectively) (p=0.01). Accordingly, an anterior offset tibial keel or stem seems to be a more suitablechoice for Indian patients undergoing primary or revision total knee arthroplasty. In the case of medial-lateral offset, weneed both medial and lateral offset stemmed implant as the medial offset is seen in 86 knees and the lateral offset is seen in39 knees almost ¼ th of the study subjects.

[学科分类] 工程和技术（综合）

[关键词] Tibial shaft axis;tibial plateau;total knee arthroplasty;computed tomography