scholarly journals The Influence of the Posterior Slope Angle and Posterior Condylar Offset in Posterior-Stabilized Total Knee Arthroplasty Was Analyzed From the Way of Constructing Flexion Gap

2021 ◽  
Author(s):  
bangwei Shen ◽  
Hao Han ◽  
Tao Huang ◽  
Xu Luo ◽  
Zi-Hao Li ◽  
...  
Keyword(s):  
Slope Angle ◽  
Flexion Angle ◽  
Posterior Stabilized ◽  
Posterior Condylar Offset ◽  
Flexion Gap ◽  
Flexion Extension ◽  
Postoperative Flexion ◽  
Posterior Condylar ◽  
Total Knee ◽  
Posterior Slope Angle

Abstract IntroductionThe purpose of this study was to compare the effects of two ways of establishing the flexion gap on the flexion angle and flexion-extension motion after posterior-stabilized （PS） prosthesis. A way for the posterior slope angle（PSA）and posterior condylar offset（PCO）were greater than preoperative, another for less than preoperative.Materials and MethodsThey are grouped according to the way flexion gaps are constructed. Data from 28 total knee arthroplasty（TKA）patients treated with propensity score match (PSM) were included. The difference of flexion angle and flexion-extension motion between the two groups was compared, and the influence of PCO and PSA on the flexion angle in the two ways was analyzed.ResultsPostoperative flexion degree of the two groups was 115.50±14.64° and 112.29±10.64° (P =0.553), and there was no statistical significance. Postoperative flexion-extension motion grade data of the decrease group was better than that of the increased group (P =0.031). Postoperative flexion angle was negatively correlated with PCO change in the increase group (r²=0.574 b '=-0.758 p=0.002).ConclusionsIncreasing the PSA and PCO to construct flexion gaps in PS TKA will cause problems with flexion-extension movements. It may be more reasonable to avoid excessive PSA and select appropriate PCO to reconstruct the flexion gap in PS prosthetic.

Posterior condylar offset influences the intraoperative soft tissue balance during posterior-stabilized total knee arthroplasty

2017 ◽  
Vol 22 (6) ◽  
pp. 1071-1076 ◽  
Author(s):  
Masanori Tsubosaka ◽  
Koji Takayama ◽  
Shinya Oka ◽  
Hirotsugu Muratsu ◽  
Ryosuke Kuroda ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Soft Tissue Balance ◽  
Posterior Stabilized ◽  
Posterior Condylar Offset ◽  
Posterior Condylar ◽  
Total Knee

scholarly journals Biomechanical Effects of Posterior Condylar Offset and Posterior Tibial Slope on Quadriceps Force and Joint Contact Forces in Posterior-Stabilized Total Knee Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Kyoung-Tak Kang ◽  
Yong-Gon Koh ◽  
Juhyun Son ◽  
Oh-Ryong Kwon ◽  
Jun-Sang Lee ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Contact Stress ◽  
Knee Arthroplasty ◽  
Tibial Slope ◽  
Posterior Stabilized ◽  
Posterior Condylar Offset ◽  
Posterior Tibial ◽  
Posterior Condylar ◽  
Total Knee ◽  
Quadriceps Force

This study aimed to determine the biomechanical effect of the posterior condylar offset (PCO) and posterior tibial slope (PTS) in posterior-stabilized (PS) fixed-bearing total knee arthroplasty (TKA). We developed ±1, ±2, and ±3 mm PCO models in the posterior direction and −3°, 0°, 3°, and 6° PTS models using a previously validated FE model. The influence of changes in the PCO and PTS on the biomechanical effects under deep-knee-bend loading was investigated. The contact stress on the PE insert increased by 14% and decreased by 7% on average as the PCO increased and decreased, respectively, compared to the neutral position. In addition, the contact stress on post in PE insert increased by 18% on average as PTS increased from −3° to 6°. However, the contact stress on the patellar button decreased by 11% on average as PTS increased from −3° to 6° in all different PCO cases. The quadriceps force decreased by 14% as PTS increased from −3° to 6° in all PCO models. The same trend was found in patellar tendon force. Changes in PCO had adverse biomechanical effects whereas PTS increase had positive biomechanical effects. However, excessive PTS should be avoided to prevent knee instability and subsequent failure.

Posterior cruciate ligament resection in total knee arthroplasty

2019 ◽  
Vol 101-B (10) ◽  
pp. 1230-1237 ◽  
Author(s):  
Babar Kayani ◽  
Sujith Konan ◽  
Saman Horriat ◽  
Mazin S. Ibrahim ◽  
Fares S. Haddad
Keyword(s):  
Total Knee Arthroplasty ◽  
Posterior Cruciate Ligament ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Limb Alignment ◽  
Flexion Gap ◽  
Flexion Extension ◽  
Total Knee ◽  
The Mean ◽  
Extension Gap

Aims The aim of this study was to assess the effect of posterior cruciate ligament (PCL) resection on flexion-extension gaps, mediolateral soft-tissue laxity, fixed flexion deformity (FFD), and limb alignment during posterior-stabilized (PS) total knee arthroplasty (TKA). Patients and Methods This prospective study included 110 patients with symptomatic osteoarthritis of the knee undergoing primary robot-assisted PS TKA. All operations were performed by a single surgeon using a standard medial parapatellar approach. Optical motion capture technology with fixed femoral and tibial registration pins was used to assess gaps before and after PCL resection in extension and 90° knee flexion. Measurements were made after excision of the anterior cruciate ligament and prior to bone resection. There were 54 men (49.1%) and 56 women (50.9%) with a mean age of 68 years (sd 6.2) at the time of surgery. The mean preoperative hip-knee-ankle deformity was 4.1° varus (sd 3.4). Results PCL resection increased the mean flexion gap significantly more than the extension gap in the medial (2.4 mm (sd 1.5) vs 1.3 mm (sd 1.0); p < 0.001) and lateral (3.3 mm (sd 1.6) vs 1.2 mm (sd 0.9); p < 0.01) compartments. The mean gap differences after PCL resection created significant mediolateral laxity in flexion (gap difference: 1.1 mm (sd 2.5); p < 0.001) but not in extension (gap difference: 0.1 mm (sd 2.1); p = 0.51). PCL resection significantly improved the mean FFD (6.3° (sd 4.4) preoperatively vs 3.1° (sd 1.5) postoperatively; p < 0.001). There was a strong positive correlation between the preoperative FFD and change in FFD following PCL resection (Pearson’s correlation coefficient = 0.81; p < 0.001). PCL resection did not significantly affect limb alignment (mean change in alignment: 0.2° valgus (sd 1.2); p = 0.60). Conclusion PCL resection creates flexion-extension mismatch by increasing the flexion gap more than the extension gap. The increase in the lateral flexion gap is greater than the increase in the medial flexion gap, which creates mediolateral laxity in flexion. Improvements in FFD following PCL resection are dependent on the degree of deformity before PCL resection. Cite this article: Bone Joint J 2019;101-B:1230–1237

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