Effects of different prosthetic instrumentations on tibial bone resection in total knee arthroplasty

AbstractOur aim was to assess the accuracy of the obtained posterior tibial slope (PTS) with a fixed angle cutting block. 247 TKAs in 213 patients were reviewed. We included 104 Legion Prosthesis, 76 U2 Knee Prosthesis, 46 NexGen LPS-Flex Prosthesis, and 21 Vanguard Knee System products. Preoperative and postoperative PTS were measured via expanded lateral tibia radiographs. For postoperative PTS, the Legion group had significantly smaller slopes than the U2 Knee group and Vanguard group. However, there was no significant difference between the Legion and NexGen groups, and no significant difference among the NexGen, U2 Knee, and Vanguard groups. Multiple linear regression showed that the different tibial lengths and preoperative PTS had statistically significant effects on postoperative PTS. However, there were weak correlations between the tibial length and PTS, and between preoperative and postoperative PTS. For TKA, although the PTS is not completely consistent with the angle of the cutting block, using conventional tibial bone resection technology with different tibial cutting instrumentations provided by various manufacturers in TKA can obtain safe PTS.

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Effects of Different Prosthetic Instrumentations on Tibial Bone Resection in Total Knee Arthroplasty

10.21203/rs.3.rs-107463/v1 ◽

2020 ◽

Author(s):

Yufeng Lu ◽

Xuechao Yuan ◽

Feng Qiao ◽

Yangquan Hao

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Knee Prosthesis ◽

Tibial Slope ◽

Full Length ◽

Bone Resection ◽

Tibial Bone ◽

Significant Difference ◽

Total Knee ◽

Alignment Angle

Abstract Objective For total knee arthroplasty (TKA) tibial bone resection, various manufacturers provide cutting blocks with fixed angles. But the accuracy of these angles is uncertain. Our aim was to assess the accuracy of the obtained posterior tibial slope (PTS) with a fixed angle cutting block.Methods 247 TKAs in 213 patients were reviewed. We included 104 Legion Prosthesis, 76 U2 Knee Prosthesis, 46 NexGen LPS-Flex Prosthesis, and 21 Vanguard Knee System products. Preoperative and postoperative PTS were measured via expanded lateral tibia radiographs. The tibial component coronal alignment angle (TCCA) was measured on postoperative standing full-length anteroposterior radiographs, and the tibia length was measured on preoperative standing full-length radiographs. Results For postoperative PTS, the Legion group had significantly smaller slopes than the U2 Knee group and Vanguard group. However, there was no significant difference between the Legion and NexGen groups, and no significant difference among the NexGen, U2 Knee, and Vanguard groups. One sample t-test indicated that only the NexGen group showed no statistical difference from the 7° PTS and 90° TCCA it aimed to provide. Multiple linear regression showed that the different tibial lengths and preoperative PTS had statistically significant effect on postoperative PTS. However, there were weak correlations between the tibial length and PTS, and between preoperative and postoperative PTS.Conclusion For TKA, using conventional tibial bone resection technology with different tibial cutting instrumentations provided by various manufacturers can obtain safe PTS. However, the PTS is not completely consistent with the angle of the cutting block.

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Effect of Posterior Tibial Slope Change on Postoperative Range of Motion and Clinical Outcomes after Posterior Cruciate-Substituting Total Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0041-1729967 ◽

2021 ◽

Author(s):

O-Sung Lee ◽

Jangyun Lee ◽

Myung Chul Lee ◽

Hyuk-Soo Han

Keyword(s):

Total Knee Arthroplasty ◽

Range Of Motion ◽

Correlation Coefficient ◽

Knee Arthroplasty ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

Posterior Tibial ◽

Clinical Scores ◽

Total Knee ◽

The Mean

AbstractThe posterior tibial slope (PTS) is usually adjusted by less than 5 degrees, without considering its individual difference, during posterior cruciate-substituting (PS) total knee arthroplasty (TKA). The effect of these individual changes of PTS would be important because clinical results depending on postoperative PTS were reported conflictingly. We investigated the effect of the change in PTS on the postoperative range of motion (ROM) and clinical scores after PS TKA. We retrospectively reviewed 164 knees from 107 patients who underwent PS TKA with a 2-year follow-up. We analyzed the preoperative and postoperative PTS, ROM, visual analog scale pain scale, Western Ontario and McMaster University Index (WOMAC), Hospital for Special Surgery Knee Score, Knee Society Score, and Forgotten Joint Score (FJS). The association of the absolute change in PTS with ROM and clinical scores was analyzed using correlation analysis and multiple regression analysis. As a result, the mean PTS and mean ROM changed from 9.6 ± 3.4 and 120.1 ± 15.4 degrees preoperatively to 2.0 ± 1.3 and 128.4 ± 9.3 degrees postoperatively, and the mean PTS change was 7.6 ± 3.5 degrees. The PTS change had no statistically significant association with the postoperative ROM and clinical scoring systems, although it did have a weak positive correlation with WOMAC function, No 10 (difficulty in rising from sitting) (correlation coefficient = 0.342, p = 0.041), and moderate positive correlation with the FJS, No. 6 (awareness when climbing stairs) (correlation coefficient = 0.470, p = 0.001). The authors concluded that the amount of change in PTS did not affect the postoperative ROM and clinical scores, although proximal tibial resection with a constant target of PTS resulted in individually different changes in the PTS after PS TKA,

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Accelerometer-Based Portable Navigation System Is Useful for Tibial Bone Cutting in Modified Kinematically Aligned Total Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0039-3402481 ◽

2019 ◽

Cited By ~ 1

Author(s):

Masanori Tsubosaka ◽

Tomoyuki Kamenaga ◽

Yuichi Kuroda ◽

Koji Takayama ◽

Shingo Hashimoto ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Navigation System ◽

Slope Angle ◽

Posterior Slope ◽

Tibial Bone ◽

Significant Difference ◽

Portable Navigation ◽

Total Knee

AbstractSeveral studies have reported better clinical outcomes following kinematically aligned total knee arthroplasty (KA-TKA) than mechanically aligned TKA. Consistent reproduction of a KA-TKA is aided by accurate tibial bone resections using computer navigation systems. This study compares an accelerometer-based portable navigation system with a conventional navigation system on tibial bone resection and clinical outcomes in KA-TKA. This study included 60 knees of patients who underwent primary KA-TKA between May 2015 and September 2017. They were randomly assigned to the OrthoPilot and iASSIST groups. A tibial bone cut was performed with 3 degree varus and 7 degree posterior slope in relation to the mechanical axis in all cases. The tibial component angle (TCA) and posterior slope angle (PSA) were evaluated by postoperative radiography, and those that deviated more than 2 degree were set as outliers. The clinical outcomes were the knee range of motion (ROM) and 2011 Knee Society Score (KSS) evaluated at 1 year postoperation. The groups were compared in terms of the TCA, PSA, number of outliers, ROM, and 2011 KSS (p < 0.05). No significant difference was observed between the groups in terms of the mean TCA, PSA, number of outliers, ROM, and categories of the 2011 KSS (objective knee indicators, symptoms, satisfaction, expectations, and functional activities). Although tibial bone cuts were performed with 3 degree varus and 7 degree posterior slope, no significant difference was observed between the OrthoPilot and iASSIST groups in terms of the accuracy of cuts or postoperative clinical result. The iASSIST was found to be a simple and useful navigation system for KA-TKA.

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