Meniscus sizing using three-dimensional models of the ipsilateral tibia plateau based on CT scans - an experimental study of a new sizing approach - Publication

Publication

Meniscus sizing using three-dimensional models of the ipsilateral tibia plateau based on CT scans - an experimental study of a new sizing approach

Journal Paper/Review - May 27, 2020

Beeler Silvan, Vlachopoulos Lazaros, Jud Lukas, Sutter Reto, Götschi Tobias, Fürnstahl Philipp, Fucentese Sandro F

Citation

Beeler S, Vlachopoulos L, Jud L, Sutter R, Götschi T, Fürnstahl P, Fucentese S. Meniscus sizing using three-dimensional models of the ipsilateral tibia plateau based on CT scans - an experimental study of a new sizing approach. J Exp Orthop 2020; 7:36.

Type

Journal Paper/Review (English)

Journal

J Exp Orthop 2020; 7

Publication Date

May 27, 2020

Issn Print

2197-1153

Brief description/objective

PURPOSE
Selection of a meniscus allograft with a similar three-dimensional (3D) size is essential for good clinical results in meniscus allograft surgery. Direct meniscus sizing by MRI scan is not possible in total meniscectomy and indirect sizing by conventional radiography is often inaccurate. The purpose of this study was to develop a new indirect sizing method, based on the 3D shape of the ipsilateral tibia plateau, which is independent of the meniscus condition.

METHODS
MRI and CT scans of fifty healthy knee joints were used to create 3D surface models of both menisci (MRI) and tibia plateau (CT). 3D bone models of the proximal 10 mm of the entire and half tibia plateau (with / without intercondylar area) were created in a standardized fashion. For each meniscus, the best fitting "allograft" couple out of all other 49 menisci were assessed by the surface distance of the 3D meniscus (best available allograft), of the 3D tibia plateau (3D-CT) and by the radiographic method of Pollard (2D-RX).

RESULTS
3D-CT sizing was significantly better by using only the half tibia plateau without the intercondylar area (p < 0.001). But neither sizing by 3D-CT, nor by 2D-RX could select the best available allograft. Compared to 2D-RX, 3D-CT sizing was significantly better for the medial, but not for the lateral meniscus.

CONCLUSIONS
Automatized, indirect meniscus sizing using the 3D bone models of the tibia plateau is feasible and more precise than the previously described 2D-RX method.. However, further technical improvement is needed to select always the best available allograft.