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The shapes of the tibial and femoral articular surfaces in relation to tibiofemoral movement

Laboratorio di Biomeccanica, Istituti Ortopedici Rizzoli, via di Barbiano n/1/10, 40136 Bologna, Italy.

V. Pinskerova, MD, Orthopaedic Surgeon

FN Motol, 1 Ortopedická Klinika UK, Vúvalu 84, Praha 5, 150 06 Czech Republic.

Correspondence should be sent to Dr S. Martelli.

We report a study of the shapes of the tibial and femoral articular surfaces in sagittal, frontal and coronal planes which was performed on cadaver knees using two techniques, MRI and computer interpolation of sections of the articular surfaces acquired by a three-dimensional digitiser.

The findings using MRI, confirmed in a previous study by dissection, were the same as those using the digitiser. Thus both methods appear to be valid anatomical tools.

The tibial and femoral articular surfaces can be divided into anterior segments, contacting from 0° to 20 ± 10° of flexion, and posterior segments, contacting from 20 ± 10° to 120° of flexion. The medial and lateral compartments are asymmetrical, particularly anteriorly. Posteromedially, the femur is spherical and is located in a conforming, but partly deficient, tibial socket. Posterolaterally, it is circular only in the sagittal section and the tibia is flat centrally, sloping downwards both anteriorly and posteriorly to receive the meniscal horns. Anteromedially, the femur is convex with a sagittal radius larger than that posteriorly, while the tibia is flat sloping upwards and forwards. Anterolaterally, both the femoral and tibial surfaces are largely deficient.

These shapes suggest that medially the femur can rotate on the tibia through three axes intersecting in the middle of the femoral sphere, but that the sphere can only translate anteroposteriorly and even then to a limited extent. Laterally, the femur can freely translate anteroposteriorly, but can only rotate around a transverse axis for that part of the arc, i.e., near extension, during which it comes into contact with the tibia through its flattened distal/medial surface as against its spherical posterior surface.

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