Decreased posterior tibial slope increases strain in the posterior cruciate ligament following total knee arthroplasty

Singerman, Robert; Dean, John C.; Pagan, Hector D.; Goldberg, Victor M.

doi:10.1016/s0883-5403(96)80167-7

Cited by 82 publications

(61 citation statements)

References 22 publications

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“…The posterior tibial slope of the knee affects the mechanics of the joint [9][10][11]. It affects the resulting shear forces at the joint when it is loaded by muscle or external forces.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Meniscal Tears and Tibial Slope on the Tibial Plateau

Alıcı

Esenyel

Esenyel³

et al. 2011

EAJM

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Objective: The geometry of the tibial plateau has a direct influence on the translation and the screw home biomechanics of the tibiofemoral joint. Little information on the relationship between the tibial slope and meniscal lesions is available. The objective of this retrospective study was to examine the effect of the tibial slope on the medial and lateral meniscus lesions in patients with intact ACLs. Materials and Methods:The MRIs and lat roentgenograms of 212 patients with meniscus lesions were examined to determine the possible effect of the tibial slope on meniscal tears. First, the anatomic axis of the proximal tibia was established. Then, the angle between the line drawn to show the tibial slopes (medial and lateral) and the line drawn perpendicular to the proximal tibial anatomic axis was established on MRI. The patients with previously detected meniscus lesions were classified into three categories: patients with only medial meniscal tear (Group 1, 90 patients); patients with only lateral meniscal tear (Group 2, 15 patients); and patients with both medial and lateral meniscal tear (Group 3, 19 patients). Group 4 had no meniscal tear (88 patients). The MRIs of the patients who had applied to the Orthopedic Outpatient Clinic with patellofemoral pain and no meniscal tear were included as the control group.

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“…The posterior tibial slope of the knee affects the mechanics of the joint [9][10][11]. It affects the resulting shear forces at the joint when it is loaded by muscle or external forces.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Meniscal Tears and Tibial Slope on the Tibial Plateau

Alıcı

Esenyel

Esenyel³

et al. 2011

EAJM

View full text Add to dashboard Cite

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“…It is defined by a tangent line to the respective tibial plateau and a line perpendicular to the longitudinal axis (LA) of the tibial bone that averages 10°(± 3°) on radiographs [9,13,16,19]. The measure reportedly influences knee kinematics [1,17] and ligament function [41,42,44]. Dejour and Bonnin reported for every 10°increase in PTS there is an anterior tibial shift of 6 mm in a monopedal stance test [13].…”

Section: Introductionmentioning

confidence: 99%

“…An experimental PTS increase (5°-20°) resulted in anterior (2.1 mm-4.6 mm) and superior (1.6 mm-4.1 mm) translation of the tibial plateau with respect to the femoral condyles [1]. Some authors presumed that with greater translation greater ligament loading occurred and placed the ACL at greater risk with an increased PTS [13,17,44]. Thus, noncontact ACL injury was associated with a greater PTS, but published data are contradictory [8,17,35,41,42,44,46,47].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors presumed that with greater translation greater ligament loading occurred and placed the ACL at greater risk with an increased PTS [13,17,44]. Thus, noncontact ACL injury was associated with a greater PTS, but published data are contradictory [8,17,35,41,42,44,46,47]. Although there was no ACL tension increase in a biomechanical study [17], computer model data [41,42] support a positive association between ACL tension and a greater PTS.…”

Section: Introductionmentioning

confidence: 99%

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Is Noncontact ACL Injury Associated with the Posterior Tibial and Meniscal Slope?

Hudek

Fuchs

Regenfelder

et al. 2011

Clinical Orthopaedics &Amp; Related Research

129

167

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Background The risk of noncontact ACL injury reportedly is increased in patients with a greater posterior tibial slope (PTS), but clinical data are inconsistent. It is unclear whether the medial and lateral PTSs have a different impact on this connection. It also is unknown whether the meniscal slope (MS) is associated with ACL injury. Patients/methods Using MRI, we compared the medial and lateral PTSs and MSs separately in 55 matched pairs of patients with isolated noncontact ACL injuries and a control group.

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“…Incorrect alignment can lead to abnormal wear [3,4], early mechanical loosening of the components [5,6], and patellofemoral problems [7,8]. Deviations of greater than 3 varus/valgus will increase the rate of loosening in the coronal plane [5,9], and the posterior tilting of the tibial component will affect the femoral rollback on the tibia, the tension of the posterior cruciate ligament, and the range of motion in the sagittal plane [4,10,11]. Anterior knee pain and patellar subluxation can be caused by the excessive internal rotation of the components in the transverse plane [12,13].…”

Section: Introductionmentioning

confidence: 99%

Comparison of robot-assisted and conventional total knee arthroplasty: A controlled cadaver study using multiparameter quantitative three-dimensional CT assessment of alignment

Moon

Hong

et al. 2012

Computer Aided Surgery

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Introduction: A functional total knee replacement has to be well aligned, which implies that it should lie along the mechanical axis and in the correct axial and rotational planes. Incorrect alignment will lead to abnormal wear, early mechanical loosening, and patellofemoral problems. There has been increased interest of late in total knee arthroplasty with robotic assistance. This study was conducted to determine whether robot-assisted total knee arthroplasty is superior to the conventional surgical method with regard to the precision of implant positioning. Materials and Methods: Twenty knee replacements, comprising ten robot-assisted procedures and ten conventional operations, were performed on ten cadavers. Two experienced surgeons performed the surgeries. Both procedures on each cadaver were performed by the same surgeon. The choice of which procedure was to be performed first was randomized. Following implantation of the prosthesis, the mechanical axis deviation, femoral coronal angle, tibial coronal angle, femoral sagittal angle, tibial sagittal angle, and femoral rotational alignment were measured via 3D CT scanning. These variables were then compared with the preoperatively planned values. Results: In the knees that underwent robot-assisted surgery, the mechanical axis deviation ranged from À1.94 to 2.13 ) in relation to the transepicondylar axis. In the conventional knee replacement group, there were two instances of outliers outside the range of 3 varus/valgus for the mechanical axis deviation. The robot-assisted knee replacements showed significantly superior femoral rotational alignment results compared with conventional surgery ( p ¼ 0.006). There was no statistically significant difference between robot-assisted and conventional total knee arthroplasty with regard to the other variables. All the measurements showed high intra-observer and inter-observer reliability. Conclusion: Robot-assisted total knee arthroplasty showed excellent precision in the sagittal and coronal planes of the 3D CT scan. In particular, the robot-assisted technique showed better accuracy in femoral rotational alignment compared to the conventional surgery, despite the fact that the surgeons who performed the operations were more experienced and familiar with the conventional method than with robot-assisted surgery. It can thus be concluded that robot-assisted total knee arthroplasty is superior to conventional total knee arthroplasty.

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Decreased posterior tibial slope increases strain in the posterior cruciate ligament following total knee arthroplasty

Cited by 82 publications

References 22 publications

Relationship between Meniscal Tears and Tibial Slope on the Tibial Plateau

Relationship between Meniscal Tears and Tibial Slope on the Tibial Plateau

Is Noncontact ACL Injury Associated with the Posterior Tibial and Meniscal Slope?

Comparison of robot-assisted and conventional total knee arthroplasty: A controlled cadaver study using multiparameter quantitative three-dimensional CT assessment of alignment

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