##article.abstract##
Objective: The tibia is the larger and medially positioned of the two bones of the leg and is involved in knee articulation. Its proximal part consists of the medial and lateral condyles whose superior surface is known as medial and lateral plateau respectively. The knee joint is commonly involved in chronic osteoarthritis which may invariably require knee replacement surgery. This surgical procedure entails excision and replacement of a portion of proximal tibial metaphysis with implants. The available tibial implants consist of excessive number of sizes that may be inappropriate for our population. Thus the need to generate proximal tibial dimensions that may assist in the manufacture of tibial implants appropriate for Nigerians becomes pertinent hence the rationale for the study.
Materials and method: One hundred and thirty one adult tibiae (right:44.3% and left:55.7%) obtained from macerated cadavers were used for the study. On the superior surface of each
condyle, the anteroposterior length (APL), transverse length (TL) , intercondylar length (ICL) and mediolateral length (MLL)were measured.
Results: The mean APL of the right tibial medial condyle was significantly (p< 0.05) longer than that of its lateral condyle (44.27±4.10 vs 39.49±3.89 mm). For the left tibia, the mean APL of the medial condyle was also significantly longer (43.55±4.38 vs 39.23±4.02 mm). The mean TL for the right tibial medial and lateral condyle was 30.30±3.42 and 30.84±3.67 mm respectively. The mean TL for the left tibial medial and lateral condyle was 30.16±3.16 and 30.59±3.30 mm respectively. The mean ICL of right tibia was 13.03±1.81 and that of the left tibia was 12.85±1.47 mm. The mean MLL of right tibia was 74.17±6.68 while that of the left tibia was 73.60±6.01mm. The differences in the various parameters between the right and left tibia were insignificant.
Conclusion: There is asymmetry between the anteroposterior length of the medial and lateral condyles. When compared with similar studies, the dimensions of the tibial condyles in Nigerians were different from those of other nationals. Thus there exists racial variations in the dimensions of tibial condyles and this has to be considered in the manufacture of tibial implants for knee arthroplasty. Results of this study may thus serve as reference values for Nigerians.
Keywords: Tibial condyle dimensions, tibial implants, Nigerians
Abstrait
Objectif: Le tibia est la partie la plus grande et la plus médiane des deux os de la jambe et est impliqué dans l’articulation du genou. Sa partie proximale est constituée des condyles médial et latéral dont la surface supérieure est respectivement appelée plateau médial et latéral. L’articulation du genou est couramment impliquée dans l’arthrose chronique qui peut nécessiter invariablement une chirurgie de remplacement du genou. Cette intervention chirurgicale implique l’excision et le remplacement d’une partie de la métaphyse tibiale proximale par des implants. Les implants tibiauxdisponibles consistent en un nombre excessif de tailles qui peuvent être inappropriées pour notre population. Ainsi, la nécessité de générer des dimensions tibiales proximales pouvant aider à la fabrication d’implants tibiaux appropriés pour les Nigérians devient pertinente, d’où la raison d’être de l’étude.
Matériel et méthode: Cent trente et un tibias adultes (droit : 44,3 % et gauche: 55,7%) obtenus à partir de cadavres macérés ont été utilisés pour l’étude. Sur la surface supérieure de chaque
condyle, la longueur antéropostérieure (APL), la longueur transversale (TL), la longueur intercondylaire (ICL) et la longueur médio-latérale (MLL) ont été mesurées.
Résultats: La moyenne APL du condyle médial tibial droit était significativement plus longue (p <0,05) que celle de son condyle latéral (44,27 ± 4,10 vs 39,49 ± 3,89 mm). Pour le tibia gauche, la moyenne APL du condyle médial était également significativement plus longue (43,55 ± 4,38 vs39,23 ± 4,02 mm). Le TL moyen pour le condyle médial et latéral tibial droit était respectivement de 30,30 ± 3,42 et de 30,84 ± 3,67mm. Le TL moyen pour le condyle médial et latéral tibial gauche était respectivement de 30,16 ± 3,16 et de 30,59 ± 3,30mm. L’ICL moyenne du genou droit était de 13,03 ± 1,81 et celle du genou gauche de 12,85 ± 1,47mm. Le MLL moyen du genou droit était de 74,17 ± 6,68 tandis que celui du genou gauche était de 73,60 ± 6,01mm. Les différences dans les divers paramètres entre le tibia droit et gauche étaient insignifiantes.
Conclusion: Il existe une asymétrie entre la longueur antéropostérieure des condyles médial et latéral. Quand comparés à des études similaires, les dimensions des condyles tibiaux chez les
Nigérians étaient différentes de celles des autresres sortissantsnationaux. Il existe donc des variations raciales dans les dimensions des condyles tibiaux et il faut en tenir compte dans la fabrication d’implants tibiaux pour arthroplastie du genou . Les résultats de cette étude peuvent donc servir de valeurs de référence pour les Nigérians.
Mots clés: dimensions tibiale de condyle, implants tibial, Nigérians
Correspondence: Dr. R.S. Ajani, Department of Anatomy, College of Medicine, University of Ibadan, Ibadan, Nigeria. E-mail: rsaajani@yahoo.co.uk
##submission.citations##
Standring S. Gray’s Anatomy, The Anatomical Basis of Clinical Practice. 39th edn. Elsevier Churchill Livingstone, New York. (2005) 1239-1244.
Servien E, Saffarini M, Lustig S, Chomel S and Neyret Ph. Lateral versus medial tibial plateau: morphometric analysis and adaptability with current tibial component design. Knee Surg. Sports Traumatol. Arthrosc. (2008) 16: 1141-1145.
Murlimanju BV, Purushothama C, Srivastava A et al. Anatomical morphometry of the tibial plateau in South Indian population. Italian Journal of Anatomy and Embryology (2016) 121(3) :258-264
S´migielski R, Becker R, Zdanowicz U and Ciszek B. Medial meniscus anatomy—from basic science to treatment. Knee Surg Sports Traumatol Arthrosc (2015) 23:8–14.
Zivanović S. Menisco-meniscal ligaments of the human knee joint. Anat Anz (1974) 135:35–42
Erkocak OF, Kucukdurmaz F, Sayar S, et al. Anthropometric measurements of tibial plateau and correlation with the current tibial implants. Knee Surg Sports Traumatol Arthrosc Sports Traumatol (2016) 24: 2990-2997.
Kwak DS, Surendran S, Pengatteeri YH, et al. Morphometry of the proximal tibia to design the tibial component of total knee arthroplasty for the Korean population. Knee (2007) 14(4):295-300.
Uehara K, Kayoda Y, Kobayashi A, et al. Anthropometry of the proximal tibia to design a total knee prosthesis for the Japanes population. The Journal of Arthroplasty (2002) 17 (8) :1028-1032.
Srivastava A, Yadav A, Thomas R.J and Gupta N. Morphometric study of tibial condylar area in the North Indian population. J. Med. Sci. Clin. Res. (2014) 2: 515-519.
Cheng FB, Ji XF, Lai Y, et.al. Three dimensional morphometry of the knee to design the total knee arthroplasty for Chinese population. Knee (2009) 16(5):341–347.
Yang, B, Song, CH, Yu, JK. et al. Intraoperative anthropometric measurements of tibial morphology: comparisons with the dimensions of current tibial implants. Knee Surg Sports Traumatol Arthrosc (2014) 22: 2924.
Küçükdurmaz F, Tuncay I, Elmadağ M and Tunçer N. Morphometry of the medial tibial plateau in Turkish knees: correlation to the current tibial components of unicompartmental kneearthroplasty. Acta Orthop Traumatol Turc (2014) 48:147–151
Urabe K, Miura H, Kuwano T, et al. Comparison between the shape of resected femoral sections and femoral prostheses used in total knee arthroplasty in Japanese patients: simulation using three-dimensional computed tomography. J Knee Surg (2003) 16:27–33
Vaidya SV, Ranawat CS, Aroojis A and Laud NS Anthropometric measurements to design total knee prostheses for the Indian population. J Arthroplasty, 2000; 15:79–98
Koyuncu E, Özgüner G, Öztürk K, et al. The Morphological Anatomy of the Menisci of the Knee Joint in Human Fetuses. Balkan Med J 2017; 34:559-566
Yue B, Varadarajan KM, Ai S, et al. Differences of knee anthropometry between Chinese and White men and women. J Arthroplasty.2011; 26(1): 124–130
Gupta C, Kumar J, Kalthur S G and D’souza AS. A morphometric study of the proximal end of the tibia in South Indian population with its clinical implications. Saudi Journal of Sports Medicine. 2015; 15(2):166-169
Ivan AS. Morphometric Study of Proximal End of Tibia; 2014. p. 75. Available from: http://www.rguhs.ac.in/cdc/onlinecdc/uploads/01_M010_25888.doc.
Ogunlade SO, Alonge TO, Omololu AB and Adekolujo OS. Clinical spectrum of large joint osteoarthritis in Ibadan, Nigeria.European Journal of Scientific Research.2005;11 (2):116-122.