Peculiarities of degenerative changes in the proximal tibia according to knee joint morphotype
DOI:
https://doi.org/10.63341/bmbr/3.2025.18Keywords:
osteoarthritis, degenerative-dystrophic diseases, morphology, radiographic parameters, gonarthrosisAbstract
This study aimed to identify the characteristics of degenerative changes in the proximal tibia, taking into account the morphological variant of the knee joint. The analysis was based on radiographic examinations of 100 cases of gonarthrosis, predominantly affecting the medial compartment. The mean age of the patients was 63.56 ± 8.10 years. Among the radiographic criteria assessed were the anatomical medial proximal tibial angle (MPTA) and the femorotibial angle (FTA). In addition, morphometric parameters of the proximal tibia were evaluated relative to an axis drawn from the intercondylar eminence to the tibial condyles (LTCA, LTPA, MTPA, MTCA), as well as relative to an axis tangential to the condyles (LTCA2, LTPA2, MTPA2, MTCA2). The morphotypes of the knee joints were determined according to a proprietary cluster-based classification system. Statistical analysis was conducted using Statistica 13 software. Statistical significance was set at p≤ 0.05. Changes in LTCA and LTCA2 observed in patients with morphotypes I, II, and III indicated a medial deviation of the tibial axis. In patients with valgus deviation of the lower limb axis and knee joint morphotype IV, the decrease in LTCA and LTCA2 values indicated further destruction of the bone and cartilage tissues of the tibial condyle within the load-bearing area of the joint. It also reflected a shift of the axis tangential to the tibial condyles medially and downward, along with an upward deviation of the axis drawn from the intercondylar eminence to the lateral condyle. Changes in the LTPA, LTPA2, MTPA, and MTPA2 angles suggested a medial deviation of the tibia. An analysis of the MTCA and MTCA2 angles in patients with morphotypes II, III, and IV confirmed a medial shift of the tibia. Conversely, a decrease in MTCA and MTCA2 values in patients with morphotype I indicated further destruction of the bone and cartilage tissues of the medial condyle, as well as a downward and medial displacement of both the axis drawn from the intercondylar eminence to the medial condyle and the axis tangential to the condyles. These findings demonstrated a variation in the morphometric parameters of the proximal tibia depending on the identified knee joint morphotype in the context of degenerative-dystrophic conditions. The results may support the refinement of personalised approaches to orthopaedic interventions in degenerative dystrophic diseases of the knee joint
Received: 09.05.2025 | Revised: 17.07.2025 | Accepted: 02.09.2025
References
Tomczyk J, Taczała Warga J, Lesman J, Sawicki J, Domżalski M. Assessment of the deformation model of the proximal tibia in the course of degenerative disease: Analysis of the 3-dimensional mathematical model. Quant Imaging Med Surg. 2022;12(8):4202–12. DOI: 10.21037/qims-21-1210
Nelson AE, Keefe TH, Schwartz TA, Callahan LF, Loeser RF, Golightly YM, et al. Biclustering reveals potential knee OA phenotypes in exploratory analyses: Data from the Osteoarthritis Initiative. PLoS One. 2022;17(5):e0266964. DOI: 10.1371/journal.pone.0266964
Langworthy M, Dasa V, Spitzer AI. Knee osteoarthritis: Disease burden, available treatments, and emerging options. Ther Adv Musculoskelet Dis. 2024;16. DOI: 10.1177/1759720X241273009
Primorac D, Molnar V, Rod E, Jeleč Ž, Čukelj F, Matišić V, et al. Knee osteoarthritis: A review of pathogenesis and state-of-the-art non-operative therapeutic considerations. Genes. 2020;11(8):854. DOI: 10.3390/genes11080854
He Y, Li Z, Alexander PG, Ocasio-Nieves BD, Yocum L, Lin H, et al. Pathogenesis of osteoarthritis: Risk factors, regulatory pathways in chondrocytes, and experimental models. Biology. 2020;9(8):194. DOI: 10.3390/biology9080194
Van Oevelen A, Van den Borre I, Duquesne K, Pizurica A, Victor J, Nauwelaers N, et al. Wear patterns in knee OA correlate with native limb geometry. Front Bioeng Biotechnol. 2022;10:1042441. DOI: 10.3389/fbioe.2022.1042441
Mullaji A, Shah R, Bhoskar R, Singh A, Haidermota M, Thakur H. Seven phenotypes of varus osteoarthritic knees can be identified in the coronal plane. Knee Surg Sports Traumatol Arthrosc. 2022;30(8):2793–805. DOI: 10.1007/s00167-021-06676-8
Mullaji A, Bhoskar R, Singh A, Haidermota M. Valgus arthritic knees can be classified into nine phenotypes. Knee Surg Sports Traumatol Arthrosc. 2022;30(9):2895–904. DOI: 10.1007/s00167-021-06796-1
Yang D, Zhou Y, Shao H, Deng W. Different deformity origins and morphological features in subtypes of valgus knees: A radiological classification system. Orthop Surg. 2022;14(1):96–103. DOI: 10.1111/os.13178
Ishibashi T, Konda S, Tamaki M, Okada S, Tomita T. Tibial morphology of symptomatic osteoarthritic knees varies according to location: A retrospective observational study in Japanese patients. Sci Rep. 2024;14(1):3250. DOI: 10.1038/s41598-024-53222-w
Kuriyama S, Watanabe M, Nakamura S, Nishitani K, Tanaka Y, Sekiguchi K, et al. Large medial proximal tibial angles cause excessively medial tibiofemoral contact forces and abnormal knee kinematics following open-wedge high tibial osteotomy. Clin Biomech. 2020;80:105190. DOI: 10.1016/j.clinbiomech.2020.105190
Itou J, Kuwashima U, Itoh M, Okazaki K. Effect of bone morphology of the tibia plateau on joint line convergence angle in medial open wedge high tibial osteotomy. BMC Musculoskelet Disord. 2022;23(1):568. DOI: 10.1186/s12891-022-05526-z
Cassar-Pullicino VN, Davies AM, editors. Measurements in musculoskeletal radiology. Berlin: Springer; 2020. 860 P. DOI: 10.1007/978-3-540-68897-6
Kylymniuk LO, Matsipura MM, Iaremyn SIu. Clustering of knee joint types affected by the degenerative-dystrophic process. Ukr Med J. 2025;2(168):1–6. DOI: 10.32471/umj.1680-3051.264438
The World Medical Association. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects [Internet]. [cited 2025 Marc 29]. Available from: https://www.wma.net/what-we-do/medical-ethics/declaration-of-helsinki/
Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine [Internet]. 1997 April 4 [cited 2025 Marc 29]. Available from: https://zakon.rada.gov.ua/laws/show/994_334#Text
Order of the Ministry of Health of Ukraine No. 690. On Approval of the Procedure for Conducting Clinical Trials of Medicinal Products and Examination of Clinical Rrial Materials and Model Regulation on Ethics Committees [Internet]. 2009 September 23 [cited 2025 Marc 29]. Available from: https://zakon.rada.gov.ua/laws/show/z1010-09#Text
Demir EB, Barça F, Dinçer A, Atilla HA, Akdoğan M, Ateş Y. Predicting the need for medial augmentation for primary total knee arthroplasty with varus deformity. Jt Dis Relat Surg. 2025;36(1):129–36. DOI: 10.52312/jdrs.2025.1973
Nilsson H, Englund M, Frobell R, Lohmander LS, Struglics A, Swärd P. Varus alignment of the hip and knee 2 years after anterior cruciate ligament injury is associated with medial tibiofemoral osteoarthritis 3 years later. J Exp Orthop. 2025;12(1):e70143. DOI: 10.1002/jeo2.70143
Zhang Z, Tao H, Zhao Y, Xiang W, Cao H, Tao F. High tibial osteotomy improves balance control in patients with knee osteoarthritis and a varus deformity. J Orthop Surg Res. 2023;18(1):538. DOI: 10.1186/s13018-023-04041-8
Zhang H, Ma J, Tian A, Lu B, Bai H, Dai J, et al. Analysis of cartilage loading and injury correlation in knee varus deformity. Medicine. 2024;103(19):e38065. DOI: 10.1097/MD.0000000000038065
Siddiqi A, Anis H, Borukhov I, Piuzzi NS. Osseous morphological differences in knee osteoarthritis. J Bone Joint Surg Am. 2022;104(9):805–12. DOI: 10.2106/JBJS.21.00892
Alruwaili SH, Park KK, Yang IH, Lee WS, Cho BW, Kwon HM. Difference between medial and lateral tibia plateau in the coronal plane: Importance of preoperative evaluation for medial unicompartmental knee arthroplasty. BMC Musculoskelet Disord. 2022;23(1):342. DOI: 10.1186/s12891-022-05298-6
Ma W, Wang F, Sun S, Ding L, Wang L, Yu T, et al. Novel ideas for the comprehensive evaluation of varus knee osteoarthritis: Radiological measurements of the morphology of the lateral knee joint. J Orthop Surg Res. 2023;18(1):196. DOI: 10.1186/s13018-023-03684-x
Wang Z, Zheng Y, Meng D, Li H, Ji C, Wang J. Anatomical imaging study on uneven settlement of the proximal tibia. Orthop Surg. 2023;15(1):239–46. DOI: 10.1111/os.13632
Kulynych M, Mochalov Yu. Anthropometric characteristics of the face in patients with congenital defects of alveolar process on maxilla before surgical intervention. Ukr J Med Biol Sport. 2023;8(1):165–70. DOI: 10.26693/jmbs08.01.165
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Bulletin of Medical and Biological Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
