Abstract
BackgroundThe fibula is only indirectly involved in the composition of the human knee joint and has therefore been neglected in the research on knee osteoarthritis. Nonuniform settlement of the proximal tibia plateau is clinically defined as when the height of the medial tibial plateau is lower than that of the lateral side in medial compartment knee osteoarthritis (KOA). The non-uniform settlement of the proximal tibia plateau may be caused by fibular support on the lateral side. Orthopedic surgeons practice partial fibulectomy based on the clinical manifestation of nonuniform settlement, and this technique has been shown to reduce pain and improve function in patients with medial compartment KOA. However, this hypothesis of the mechanism of nonuniform settlement lacks an anatomical basis.MethodsThe P45 polyester plastination technique was used to prepare sections of the proximal tibiofibular joint to investigate the distribution of the bone trabeculae in the region of the lateral tibial plateau.ResultsThere was uneven distribution of trabeculae in the lateral condyle of the tibia and the head and neck of the fibula. The fibula and the posterolateral cortex of the shaft of the tibia united to form an arch beam via the tibiofibular joint. Many thick, dense trabeculae were present in a longitudinal direction above the tibiofibular arch.ConclusionsThe fibula supports the lateral tibial plateau, and the trabeculae were concentrated above the tibiofibular arch.
Highlights
Knee osteoarthritis (KOA), a degenerative joint condition, is one of the most prevalent chronic health conditions in the world, and is characterized by synovial membrane inflammation, subchondral bone sclerosis, articular cartilage degradation, and osteophyte formation [1]
For OA limited to the medial compartment of the knee, high tibial osteotomy (HTO) or unicompartmental arthroplasty (UKA) may be used to avoid or postpone total knee arthroplasty (TKA) [5]
Given the risks and high cost inherent with those surgeries, orthopedic surgeons in China have carried out partial fibulectomy, based on the manifestation of nonuniform settlement, and this simple surgical technique has been shown to be effective in reducing pain and improving function in patients with medial compartment OA [4]
Summary
There was uneven distribution of trabeculae in the lateral condyle of the tibia and the head and neck of the fibula. The fibula and the posterolateral cortex of the shaft of the tibia united to form an arch beam via the tibiofibular joint. Dense trabeculae were present in a longitudinal direction above the tibiofibular arch
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