Anatomical Basis of the Support of Fibula to Tibial Plateau and Its Clinical Significance

Background: Partial fibulectomy always was used to treat knee osteoarthritis. The settlement of the nonuniform proximal tibia plateau is clinically defined as the height of the medial tibial platform was lower than that of the lateral side in the medial compartment knee osteoarthritis (KOA). The reason for the unapparent is caused by fibular support on the lateral side. Orthopedic surgeons practiced partial fibulectomy based on the theory of nonuniform settlement, and the effect of reduce pain and improve function in patients with osteoarthritis was significant. However, this hypothesis of nonuniform settlement is still lacking an anatomical basis.MethodsThe P45 section technique was used to focus the distribution of the bone trabeculae on the tibial-fibular region.ResultsThe distribution of the bone trabeculae was uneven in the lateral condyle of the tibia and the head and neck of the fibula. The bone trabeculae with uneven distribution of tibia and fibula in space might form a triangle. The fibula and the posterolateral bone cortex of the shaft of the tibia united to form an arch beam via the tibiofibular joint. In the meantime, a lot of thick and dense trabeculae were present in a longitudinal direction on the tibiofibular arch.ConclusionsThe fibula supports the lateral tibial plateau, but the trabeculae were concentrated on the tibiofibular arch.