Effect of Tibial Slope or Posterior Cruciate Ligament Release on Knee Kinematics

Jôjima, Hiroshi; Whiteside, Leo A.; Ogata, Kosuke

doi:10.1097/01.blo.0000138960.57680.60

Cited by 71 publications

(47 citation statements)

References 6 publications

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“…In contrast, an inadequate PSA or the creation of a tibial anterior slope forces the weak anterior cancellous bone to support the femoral component and increases the possibility of anterior subsidence [13,17]. It also limits further flexion due to the tight flexion gap [17,20,28]. Thus, it is important to determine the proper PSA.…”

Section: Discussionmentioning

confidence: 99%

“…Bellemans et al [2] reported in a cadaveric study that 1.7°of additional flexion could be obtained by increasing the PSA as much as 1°. However, an excessive PSA may induce anteroposterior instability after TKA, which may cause anterior subluxation of the tibial component, increase the wear on the posterior portion of the polyethylene surface, and cause aseptic loosening [1,17,28]. Impingement of posterior femoral condyles may also occur during knee flexion due to the limitation of femoral rollback, and ROM may be limited.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, PSA increase may be more effective than PCL recession in cases with multidirectional tightness of the flexed knee [17]. In cruciateretaining TKA, an appropriate PSA maintains the tension of the PCL properly and facilitates femoral rollback during knee flexion [17]. Proper femoral rollback increases the ROM and shifts the contact point between the femur and the tibia backward, which allows the relatively strong posterior tibial cancellous bone to support the femur [13,17].…”

Section: Discussionmentioning

confidence: 99%

“…In cruciateretaining TKA, an appropriate PSA maintains the tension of the PCL properly and facilitates femoral rollback during knee flexion [17]. Proper femoral rollback increases the ROM and shifts the contact point between the femur and the tibia backward, which allows the relatively strong posterior tibial cancellous bone to support the femur [13,17]. Walker and Garg [26] reported that knees with PSAs of 10°could flex 30°more than those with PSAs of 0°in cruciate-retaining TKA.…”

Section: Discussionmentioning

confidence: 99%

“…Whereas PCL recession reduces only anteroposterior tightness in flexion, PSA increase reduces the varus, valgus, anteroposterior, and rotational tightness in flexion. Thus, PSA increase may be more effective than PCL recession in cases with multidirectional tightness of the flexed knee [17]. In cruciateretaining TKA, an appropriate PSA maintains the tension of the PCL properly and facilitates femoral rollback during knee flexion [17].…”

Section: Discussionmentioning

confidence: 99%

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Comparative study of tibial posterior slope angle following cruciate-retaining total knee arthroplasty using one of three implants

Bae

Song

Yoon

et al. 2011

International Orthopaedics (SICOT)

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Purpose Pre-and postoperative tibial posterior slope angles (PSAs) were assessed in patients who underwent cruciateretaining total knee arthroplasty (TKA). Material and methods A total of 386 cruciate retaining TKA were performed in 308 patients and retrospectively reviewed. Based on the prostheses, 202 cases using NexGen® were classified as group I, 120 cases using PFC sigma® as group II, and 64 cases using Vanguard® as group III. Postoperative PSA of groups I, II, and III were compared. Results In groups I, II, and III, postoperative PSA was 6.0˚, 6.0˚, and 4.5˚, respectively (p<0.001). Between preoperative measurement and final follow-up examination, mean knee score (59.7 to 97.3), function score (54.2 to 90.5), and range of motion (ROM; 126.7°to 132.2°) improved. These three values did not differ significantly among groups. Conclusions The 3°slope of the Vanguard® polyethylene insert caused the difference in PSAs. This design characteristic should be considered when using this implant in TKA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Comparative study of tibial posterior slope angle following cruciate-retaining total knee arthroplasty using one of three implants

Bae

Song

Yoon

et al. 2011

International Orthopaedics (SICOT)

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Comparison of postoperative clinical outcome in medial‐pivotal and gradually reducing radius design cruciate‐retaining total knee arthroplasty—A multicenter analysis of propensity‐matched cohorts

Takahashi,

Hatayama,

Nishino

et al. 2024

J. exp. orthop.

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PurposeTo clarify differences in surgery duration, postoperative knee range of motion (ROM), anterior and posterior (AP) laxity, and Forgotten Joint Score (FJS) in patients undergoing medial‐pivot (MP) and GRADIUS cruciate‐retaining (CR) total knee arthroplasty (TKA) surgeries.MethodsWe examined patients who underwent either MP or CR TKA at six different Japanese centres. Patients were propensity score matched for age, sex, and preoperative hip‐knee angle (HKA). We compared the groups' average surgery duration, postoperative knee ROM, AP laxity, and FJS 1 year after surgery.ResultsThere were 86 study patients: 43 MP and 43 CR TKA matched for age, sex, and preoperative HKA. The MP group enjoyed a significantly shorter surgery duration (89.1 ± 10.9 mins vs. 95.7 ± 12.0 mins, p = 0.0091) and significantly better postoperative knee flexion than the CR group (123.7 ± 9.1° vs. 115.3 ± 12.4°, p < 0.001). The MP had significantly smaller postoperative AP laxity with 30° of knee flexion than the CR group (3.4 ± 1.3 vs. 5.6 ± 2.2 mm, p < 0.001). Conversely, postoperative AP laxity with 90° of knee flexion was significantly larger for the MP group (3.6 ± 1.3 vs. 2.7 ± 1.9 mm, p = 0.0098). There were no between‐group differences in postoperative FJS.ConclusionsThe MP group showed better postoperative knee flexion, midrange AP knee stability, and shorter surgery duration.Level of EvidenceLevel III, retrospective comparative study.

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Influence of tibial component posterior slope on in vivo knee kinematics in fixed-bearing total knee arthroplasty

et al. 2006

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ABSTRACT:The relation between prosthesis component kinematics and posterior slope of the tibial component in total knee arthroplasty is much debated. Three-dimensional kinematics of the replaced knee was obtained by video fluoroscopy in 23 knees treated by cruciate-retaining or cruciatesubstituting arthroplasty. Relative position and orientation of the metal components were calculated in stair ascending, getting up from and sitting down on a chair, and single step up-and-down. Significant correlations were found between tibial component posterior slope and anteroposterior position of tibiofemoral lateral contact and between this slope and maximum knee flexion. These correlations were task and design specific. However, the average of the tibiofemoral contact positions over all three motor tasks was slightly posterior to the midline of the tibial base plate, reaching at most 84% of its anteroposterior dimension. Performing a posterior slope of the tibial cut does not put total knee arthroplasty with high conforming designs at higher risk of failure, even when large posterior inclinations need to be achieved. ß

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Effect of Tibial Slope or Posterior Cruciate Ligament Release on Knee Kinematics

Cited by 71 publications

References 6 publications

Comparative study of tibial posterior slope angle following cruciate-retaining total knee arthroplasty using one of three implants

Comparative study of tibial posterior slope angle following cruciate-retaining total knee arthroplasty using one of three implants

Comparison of postoperative clinical outcome in medial‐pivotal and gradually reducing radius design cruciate‐retaining total knee arthroplasty—A multicenter analysis of propensity‐matched cohorts

Influence of tibial component posterior slope on in vivo knee kinematics in fixed-bearing total knee arthroplasty

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