Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020
The tibial spine sign does not indicate cartilage damage in the central area of the distal lateral femoral condyle.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Boettner Friedrich, Springer Bernhard, Windhager Reinhard, Waldstein Wenzel
Аннотация
PURPOSE: A radiographic overlap of the lateral femoral condyle and the lateral tibial spine ('tibial spine sign') might indicate lateral compartment cartilage damage and might be considered a contraindication for unicompartmental knee arthroplasty (UKA). Therefore, the following research questions were asked: (1) does the presence of a 'tibial spine sign' on radiographs correlate with cartilage lesions on the medial aspect of the lateral femoral condyle on corresponding MRIs?; (2) do cartilage lesions on the medial aspect of the lateral femoral condyle indicate cartilage damage in the central area of the distal lateral femur?; and 3) is the 'tibial spine sign' impacted by the degree of varus deformity, the amount of coronal tibiofemoral subluxation or the functional status of the ACL?
METHODS: One hundred consecutive knees with varus OA in 84 patients were prospectively included. The relationship of the lateral femoral condyle and the tibial spine was graded from 0 to 2 based on the degree of overlap on AP standing knee radiographs. On MRI, cartilage on the medial aspect of the lateral femoral condyle was assessed. Cartilage in the weight-bearing area of the distal lateral femur was analysed according to the OARSI system.
RESULTS: The 'tibial spine sign' assessment correlated well with the degree of cartilage damage on the medial aspect of the lateral condyle (rs = 0.7, p < 0.001) but did not impact histological OARSI grades in the central weight bearing area of the lateral condyle (n.s.). Mechanical varus and tibiofemoral subluxation were not associated (n.s.) with a positive tibial spine sign. Knees with suggestive ACL insufficiency on MRI had more often a positive tibial spine sign; however, this difference was not statistically significant (n.s.).
CONCLUSION: A positive tibial spine sign does not indicate histologic cartilage damage in the central area of the distal lateral femur and may not be considered a contraindication for medial UKA.
LEVEL OF EVIDENCE: Level III, diagnostic study.
METHODS: One hundred consecutive knees with varus OA in 84 patients were prospectively included. The relationship of the lateral femoral condyle and the tibial spine was graded from 0 to 2 based on the degree of overlap on AP standing knee radiographs. On MRI, cartilage on the medial aspect of the lateral femoral condyle was assessed. Cartilage in the weight-bearing area of the distal lateral femur was analysed according to the OARSI system.
RESULTS: The 'tibial spine sign' assessment correlated well with the degree of cartilage damage on the medial aspect of the lateral condyle (rs = 0.7, p < 0.001) but did not impact histological OARSI grades in the central weight bearing area of the lateral condyle (n.s.). Mechanical varus and tibiofemoral subluxation were not associated (n.s.) with a positive tibial spine sign. Knees with suggestive ACL insufficiency on MRI had more often a positive tibial spine sign; however, this difference was not statistically significant (n.s.).
CONCLUSION: A positive tibial spine sign does not indicate histologic cartilage damage in the central area of the distal lateral femur and may not be considered a contraindication for medial UKA.
LEVEL OF EVIDENCE: Level III, diagnostic study.