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Articular surface of the medial proximal tibia is aligned parallel to the ground in three-dimensional space under weight-bearing conditions in healthy and varus osteoarthritic knees

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To test the hypothesis that an inclined articular surface on the medial proximal tibia is aligned more parallel to the ground in three-dimensional (3D) space under weight-bearing (WB) conditions (parallel phenomenon) than under non-WB (NWB) conditions in healthy and varus osteoarthritic knees.

Methods

We examined 55 healthy knees (26 women, 29 men; mean age, 70 ± 6 years) and 108 varus osteoarthritic knees (66 women, 16 men; mean age, 74 ± 7 years). For the evaluation under WB conditions, a 3D assessment system was used on biplanar long-leg radiographs and 3D bone models using a 3D-to-2D image registration technique. In addition, the least square method was used to determine the approximation plane. The angles between the normal vector for the approximation plane of an articular surface on the medial proximal tibia and each axis of the tibial or world coordinate system were calculated.

Results

Morphologically, the inclination of the approximation plane was steeper in osteoarthritic knees than in healthy knees (p < 0.0001). The approximation plane was aligned more parallel to the ground under WB conditions than under NWB conditions in healthy (p < 0.0001) and osteoarthritic knees (p < 0.0001).

Conclusions

The parallel phenomenon in the medial proximal tibia was confirmed for healthy and varus osteoarthritic knees. The medial proximal tibia plays an important role in the parallel phenomenon, assumingly associated with varus alignment and varus thrust. The inclination of the medial proximal tibia may become a new parameter for imaging investigations.

Level of evidence

III.

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Acknowledgements

The authors would like to thank all staff members of the department: Drs. Sakamoto M, Endo N, Watanabe S, Yamanaka K, Takahashi Y, Yamagiwa H, Ariumi A, Hokari R, Someya K, Fujita Y, Hata R. The authors would also like to thank all staff members of LEXI Corporation, Tokyo, Japan for their technical support.

Funding

This study received KAKENHI from Grants–in–aid for scientific research in Japan society for the promotion of science.

Author information

Authors and Affiliations

  1. Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori Chuo-ku, Niigata City, Niigata, 951-8510, Japan

    Tomoharu Mochizuki, Osamu Tanifuji, Ryota Katsumi & Hiroshi Koga

  2. Department of Orthopaedic Surgery, Nioji Onsen Hospital, Niigata, Japan

    Yoshio Koga

  3. Department of Mechanical and Production Engineering, Faculty of Engineering, Niigata University, Niigata, Japan

    Takahiro Mori & Yuji Tanabe

  4. Niigata Institute for Health and Sports Medicine, Niigata, Japan

    Katsutoshi Nishino

  5. School of Health Sciences, Faculty of Medicine, Niigata University, Niigata, Japan

    Koichi Kobayashi

  6. Department of Orthopaedic Surgery, Niigata Medical Center, Niigata, Japan

    Takashi Sato

  7. Department of Health and Sports, Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan

    Go Omori

Authors
  1. Tomoharu Mochizuki
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  2. Yoshio Koga
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  3. Takahiro Mori
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  6. Osamu Tanifuji
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  7. Takashi Sato
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  8. Ryota Katsumi
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  9. Hiroshi Koga
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  10. Go Omori
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  11. Yuji Tanabe
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Corresponding author

Correspondence to Tomoharu Mochizuki.

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Mochizuki, T., Koga, Y., Mori, T. et al. Articular surface of the medial proximal tibia is aligned parallel to the ground in three-dimensional space under weight-bearing conditions in healthy and varus osteoarthritic knees. Knee Surg Sports Traumatol Arthrosc 28, 3232–3239 (2020). https://doi.org/10.1007/s00167-019-05829-0

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