Tibial cartilage !

The tibial cartilage is the smooth layer covering the top of the shin bone inside the knee; it lets the joint glide and spreads load.

Official name: Articular cartilage of tibial plateau

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What it is

Articular cartilage covering the top of the tibia, partly under the menisci.

What it does

Lets the joint glide with very little friction and spreads load across the bone.

Key facts

Where: Medial and lateral tibial plateaus, partly covered by the menisci
Function: Hyaline articular cartilage; low-friction gliding; spreads load; avascular, nourished by synovial fluid

Relations

Above: Femoral condyle cartilage; the menisci over the outer part of each plateau
In front: Anterior cruciate ligament footprint and the anterior meniscal horns in front of the intercondylar eminence; infrapatellar fat pad
Behind: Posterior cruciate ligament footprint and the posterior meniscal horns behind the plateaus
Deep: Subchondral bone of the plateaus

How to find it

The tibiofemoral joint line can always be felt. With the knee slightly bent it lies just behind the lower tip of the patella; on the medial side a small triangular hollow, framed by the edge of the patella, the medial femoral condyle and the top of the medial tibial condyle, marks the joint. At arthroscopy the plateau is probed beneath the femoral condyle with the knee in varus or valgus.

On imaging

Standing and Rosenberg views for joint-space narrowing; long-leg standing views show varus or valgus load. MRI shows cartilage loss and bone marrow lesions. In plateau fractures, CT measures the step and depression of the joint surface.

Common problems

Cartilage injuries (focal defects) from sports or a twisting injury.
Osteoarthritis: gradual wear of the cartilage, causing pain and stiffness.

How it is diagnosed

Symptoms and exam; X-rays show joint-space narrowing in arthritis; MRI shows cartilage defects.

Treatment

Physical therapy, weight management, activity changes; medicines or injections for pain.
Surgery for focal defects: microfracture, cell-based repair, or osteochondral grafts (including osteochondral allograft from a donor).
Knee replacement for advanced arthritis.

Clinical notes

A residual step in the joint surface after a plateau fracture leads to post-traumatic arthritis
High tibial osteotomy shifts load from a worn medial compartment to the healthier lateral one in younger, active people
Unicompartmental knee replacement resurfaces only the worn compartment when the rest of the joint is preserved

Development

Retained hyaline cartilage of the embryonic model of the upper tibia; the joint cavity appears when the mesenchyme between femur and tibia loosens. The proximal tibial epiphysis starts to ossify around birth.

Test yourself

Think of the answer, then tap the question to see it.

Which compartment of the knee is the commonest site of osteoarthritis, and with what alignment?

The medial compartment, linked to varus alignment.

What does chondrocalcinosis look like on a knee X-ray?

Fine lines of calcium pyrophosphate within the tibial cartilage and menisci.

What is the aim of a high tibial osteotomy?

To shift load from a worn medial compartment to the healthier lateral one, in younger, active people.

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2): cartilago articularis TA2 382
Official Spanish (DeCS): Cartílago articular de la tibia (platillos) DeCS D002358
English (TA2): Articular cartilage of tibial plateau

Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Bony Pelvis and Lower Limb, Knee; Anatomy of the Human Body (20th ed.): Surface Anatomy of the Lower Extremity (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain; Anatomy of the Human Body (20th ed.): Development of the Joints (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.

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Representative model, for educational purposes only.

Tibial cartilage highlighted on the Durgical 3D model