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Radiographic sizing for meniscal transplantation using 3-D CT reconstruction
Mark McConkey1, Craig Lyon, D Lee Bennett
1Department of Orthopaedics and Rehabilitation, University of Iowa, 2701 Prairie Meadow Drive, Iowa City, IA 52242, USA. mark_mcconkey@hotmail.com
The Journal of Knee Surgery
|October 13, 2012
Summary
Three-dimensional computed tomography (3-D CT) scans provide more accurate tibial plateau measurements than plain radiographs (XR) for meniscus transplantation. This improved accuracy in sizing may reduce allograft mismatch and subsequent knee degeneration.
Area of Science:
- Orthopedic surgery
- Biomedical imaging
- Knee biomechanics
Background:
- Allograft size mismatch in meniscus transplantation leads to elevated contact pressures and premature knee degeneration.
- Accurate preoperative assessment of tibial plateau dimensions is crucial for successful meniscus allograft sizing.
Purpose of the Study:
- To compare the accuracy and reliability of three-dimensional computed tomography (3-D CT) versus plain radiographs (XR) for sizing the tibial plateau in the context of meniscus transplantation.
Main Methods:
- 16 cadaveric knees underwent anteroposterior (AP) and lateral XR, 3-D CT reconstructions, and direct anatomic measurements of sagittal and coronal hemiplateau dimensions.
- Measurements from imaging modalities were compared against disarticulated specimen measurements.
Main Results:
- 3-D CT measurements were significantly closer to anatomic values than XR measurements across all dimensions (p < 0.0001).
- CT achieved 100% accuracy within 5 mm and 71.9% within 2 mm, compared to 76.5% and 34.4% for XR, respectively.
- CT demonstrated significantly higher accuracy within 2 mm for the lateral meniscus on AP and lateral views (p = 0.0011, p = 0.0039).
Conclusions:
- 3-D CT offers superior accuracy and reliability in measuring tibial plateau dimensions compared to plain XR.
- Utilizing 3-D CT for preoperative planning can potentially minimize allograft size mismatch in meniscus transplantation, thereby reducing the risk of knee degeneration.