The tibial plateau is the proximal tibia’s flattened surface that supports the femoral condyles.
The tibial plateau is the superior, horizontal surface of the proximal tibia that articulates with the femoral condyles to form the primary weight-bearing surfaces of the knee joint. It consists of two distinct concave regions — the medial and lateral articular surfaces — separated by the intercondylar eminence. The plateau plays a vital role in load transmission, joint stability, and movement of the knee. As a major component of the tibiofemoral articulation, it is critical for maintaining proper alignment and shock absorption during gait and standing.
The tibial plateau comprises two asymmetric articular surfaces — the medial tibial plateau and the lateral tibial plateau — along with the central intercondylar region. The surface is lined with hyaline cartilage and reinforced internally by dense trabecular bone supporting compressive loads from the femur. The overall shape of the plateau is wider anteroposteriorly than mediolaterally and is slightly concave on the medial side and flat or slightly convex laterally.
The central non-articular area of the tibial plateau is the intercondylar area, divided into:
The tibial plateau is located at the proximal end of the tibia, directly beneath the femoral condyles. It forms the inferior articular surface of the knee joint and lies deep to the quadriceps tendon and patella. It is subcutaneous medially and lies just below the skin surface in thin individuals.
The tibial plateau forms the lower half of the tibiofemoral joint — the main component of the knee joint.
Component | Articulating Surface | Joint Type |
---|---|---|
Medial compartment | Medial tibial plateau with medial femoral condyle | Synovial hinge (modified) |
Lateral compartment | Lateral tibial plateau with lateral femoral condyle | Synovial hinge (modified) |
Both the medial and lateral tibial plateaus support the respective menisci — crescent-shaped fibrocartilaginous structures that enhance joint congruency and protect underlying cartilage.
Several key ligaments insert into the intercondylar areas of the tibial plateau:
Ligament | Attachment Site | Function |
---|---|---|
Anterior cruciate ligament (ACL) | Anterior intercondylar area | Prevents anterior translation of the tibia |
Posterior cruciate ligament (PCL) | Posterior intercondylar area | Prevents posterior translation of the tibia |
Medial meniscus | Anterior and posterior horns attach to medial side of intercondylar region | Load distribution and joint stabilization |
Lateral meniscus | Anterior and posterior horns attach to lateral side of intercondylar region | Load distribution and joint stabilization |
The tibial plateau receives its blood supply from the genicular arteries, branches of the popliteal artery:
The vascularity is rich in the subchondral bone but limited in the central cartilage-bearing areas, which contributes to poor healing potential in certain injuries.
The innervation of the tibial plateau and surrounding structures is provided by:
The proximal tibial epiphysis, including the plateau, ossifies from a secondary ossification center that appears after birth and fuses with the shaft in late adolescence. The intercondylar eminence develops as part of this ossification process.
Imaging the tibial plateau is essential in diagnosing joint pathology, trauma, or degenerative changes.
Special views like Schuss view or Rosenberg view can better show early joint space narrowing, particularly in the medial compartment.