Glossary
Tibial plateau
Quick answer
The tibial plateau is the broad, nearly flat top of the shin bone that forms the floor of the knee joint. Its inner and outer halves are covered with cartilage and topped by the menisci, which cushion the femur above, as knee surgeon Dr. Pablo Gelber explains at Aman Hospital in Doha.
What it is
The plateau has two parts: the medial plateau on the inner side, which is larger and slightly cupped, and the lateral plateau on the outer side, which is smaller and slightly domed. A ridge of bone between them, the tibial spines, is where the cruciate ligaments and the meniscal roots attach. The slope of the plateau from front to back varies between people and influences the strain on the cruciate ligaments.
Why it matters for patients
The plateau takes the full load of each step, so it is involved in many problems. High-energy injuries, such as road traffic accidents or falls from a height, and lower-energy falls in people with weaker bones, can fracture it. A tibial plateau fracture extends into the joint surface, and restoring a smooth surface matters for the long-term health of the knee.
After an ACL tear, MRI often shows bone bruising on the back of the lateral plateau. Over years, wear of the plateau cartilage, usually on the inner side, is part of knee osteoarthritis. A steep slope is one of the factors surgeons consider in repeated ACL failure.
Frequently asked questions
Does every tibial plateau fracture need surgery?
No. Undisplaced fractures are often treated with a brace and a period of limited weight-bearing. Fractures that step or widen the joint surface, or make the knee unstable, usually need surgery.
What is a bone bruise on the tibial plateau?
It is bleeding and swelling inside the bone after an impact or twist, seen on MRI. It usually settles over weeks to months and often accompanies ligament injuries.
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