Influence of posterior tibial slope on three-dimensional femorotibial alignment under weightbearing conditions in healthy Japanese elderly people

2021 ◽  
pp. 1-12
Author(s):  
Ryota Katsumi ◽  
Takashi Sato ◽  
Tomoharu Mochizuki ◽  
Satoshi Watanabe ◽  
Osamu Tanifuji ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
External Rotation ◽  
Weight Bearing ◽  
Linear Regression Analysis ◽  
Three Dimensional ◽  
Tibial Slope ◽  
Rotational Alignment ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Japanese Elderly

BACKGROUND: Assessment of three-dimensional (3D) femorotibial alignment is essential for successful knee osteoarthritis treatment in the elderly. The complex morphology of the posterior tibial slope (PTS) might have an influence on sagittal and rotational alignment and the positional relationship between the femur and tibia in the anterior–posterior (AP) direction under weight-bearing conditions. OBJECTIVE: This study aimed to clarify the association between the PTS and 3D femorotibial alignment under weight-bearing conditions in healthy Japanese elderly individuals. METHODS: We investigated the 3D femorotibial alignment of 110 lower extremities of 55 healthy individuals (26 women, 29 men, mean age: 70 ± 6 years). Using our previously reported 3D-to-2D image registration technique, we evaluated the 3D hip-knee-ankle angle (3DHKA) in the sagittal plane, rotational alignment, and the distance between the femoral and tibial origins in the AP direction (tibial AP position) as femorotibial alignment parameters under weight-bearing conditions. We assessed the medial and lateral PTS and their angular difference (PTS difference) as PTS parameters. Stepwise multiple linear regression analysis was performed using PTS parameters and other possible confounders (age, sex, height, and weight) as the independent variables and femorotibial alignment parameters as the dependent variable. RESULTS: Weight (𝛽 = 0.393, p < 0.001) and lateral PTS (𝛽 = 0.298, p < 0.001) were the predictors associated with 3DHKA in the sagittal plane. Lateral PTS (𝛽 = 0.304, p = 0.001) was the only predictor associated with the tibial AP position. Sex (𝛽 = −0.282, p = 0.002) and PTS difference (𝛽 = −0.231, p = 0.012) were associated with rotational alignment. CONCLUSIONS: We found that a steeper lateral PTS resulted in a more flexed knee and anterior tibia. The PTS difference was positively correlated with tibial external rotation. Our data could be used as the standard reference for realignment surgery to ensure PTS is appropriately maintained.

Postoperative femoral anteroposterior position while standing correlates with the posterior tibial slope and posterior femoral condylar offset in medial pivot total knee arthroplasty

2021 ◽  
pp. 1-14
Author(s):  
Yuki Takahashi ◽  
Takashi Sato ◽  
Tomoharu Mochizuki ◽  
Satoshi Watanabe ◽  
Osamu Tanifuji ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Tibial Slope ◽  
Assessment System ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Medial Pivot ◽  
Total Knee

BACKGROUND: After total knee arthroplasty (TKA), the femur tends to be located posteriorly under weight-bearing (WB) conditions, and a paradoxical femoral anterior motion occurs, leading to joint instability. OBJECTIVE: We aimed to clarify factors which affect the postoperative femoral anteroposterior position relative to the tibia under WB conditions (A-P position) in medial pivot (MP) TKA. METHODS: Among 126 knees (81 women) with primary TKA using MP prosthesis for varus osteoarthritic knees, 70 knees had cruciate-retaining inserts (CR) with the reduced conformity and 56 knees had cruciate-substituting inserts (CS) with the full conformity. Using the three-dimensional (3D) assessment system, the associations between the A-P position and the factors including pre- and postoperative lower extremity alignment, component positions, and posterior femoral condylar offset (PCO), were assessed regarding the type of inserts. RESULTS: Significant correlations were seen between the A-P position and posterior tibial slope (PTS), medial PCO, and lateral PCO. Regarding the difference between the two inserts, the PTS, medial PCO, and lateral PCO significantly correlated with the A-P position in the CR, but only the PTS correlated in the CS. CONCLUSIONS: The increased PTS and decreased PCO were the dominant factors for the A-P position in MP TKA.

scholarly journals Measurement of femoral posterior condylar offset and posterior tibial slope in normal knees based on 3D reconstruction

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Liangxiao Bao ◽  
Shengwei Rong ◽  
Zhanjun Shi ◽  
Jian Wang ◽  
Yang Zhang
Keyword(s):  
Three Dimensional ◽  
Surgical Techniques ◽  
Inverse Correlation ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Lateral Side ◽  
Posterior Condylar Offset ◽  
Posterior Tibial ◽  
Significant Difference ◽  
Posterior Condylar

Abstract Background Femoral posterior condylar offset (PCO) and posterior tibial slope (PTS) are important for postoperative range of motion after total knee arthroplasty (TKA). However, normative data of PCO and PTS and the correlation between them among healthy populations remain to be elucidated. The purpose of this study was to determine PCO and PTS in normal knees, and to identify the correlation between them. Methods Eighty healthy volunteers were recruited. CT scans were performed followed by three-dimensional reconstruction. PCO and PTS were measured and analyzed, as well as the correlation between them. Results PTS averaged 6.78° and 6.11°, on the medial and lateral side respectively (P = 0.002). Medial PCO was greater than lateral (29.2 vs. 23.8 mm, P <  0.001). Both medial and lateral PCO of male were larger than female. On the contrary, male medial PTS was smaller than female, while there was no significant difference of lateral PTS between genders. There was an inverse correlation between medial PCO and PTS, but not lateral. Conclusions Significant differences exhibited between medial and lateral compartments, genders, and among individuals. An inverse correlation exists between PCO and PTS in the medial compartment. These results improve our understanding of the morphology and biomechanics of normal knees, and subsequently for optimising prosthetic design and surgical techniques.

scholarly journals The effect of the sagittal plane osteotomy inclination on the posterior tibial slope in medial open wedge HTO: experimental study with a square column model

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sang Won Moon ◽  
Ji Young Ryu ◽  
Sung-Jae Lee ◽  
Sang Won Woo ◽  
Sin Hyung Park ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
3D Printer ◽  
Open Wedge ◽  
Correction Angle ◽  
Posterior Slope ◽  
Column Model ◽  
Posterior Tibial ◽  
Open Wedge Hto

Abstract Background Medial open-wedge high tibial osteotomy (HTO) is an effective and safe treatment method for medial osteoarthritis of the knee. However, unintended changes in the posterior tibial slope (PTS) may occur. Several factors cause PTS alterations after medial open-wedge HTO; however, research on sagittal-plane osteotomy inclination (SPOI) in relation to the PTS is sparse. The purpose of this study was to evaluate whether the SPOI affects changes in the PTS after medial open-wedge HTO. The hypothesis was that an SPOI parallel to the PTS causes no change in the PTS after medial open-wedge HTO. Methods A square column model with a 10° posterior slope was produced using two three-dimensional (3D) programs and a 3D printer. Then, a series of medial open-wedge HTO procedures was performed on the square column model through virtual simulation using the two 3D programs, and an actual simulation was conducted using a 3D printer, a testing machine and a measurement system. The SPOI was divided into four types: ① SPOI 20° (posterior-inclined 10° osteotomy), ② SPOI 10° (osteotomy parallel to posterior slope), ③ SPOI 0° (anterior-inclined 10° osteotomy), and ④ SPOI − 10° (anterior-inclined 20° osteotomy). The correction angle was increased at intervals of 5° from 0° to 30°. The change in posterior slope was measured in the sagittal plane. Results The posterior slope was increased in SPOI 20° (posterior-inclined 10° osteotomy), maintained in SPOI 10° (osteotomy parallel to posterior slope), and decreased in SPOI 0° (anterior-inclined 10° osteotomy) and SPOI − 10° (anterior-inclined 20° osteotomy) based on the correction angle. Conclusions In this study using a square column model, the SPOI affected the change in the PTS, and an SPOI parallel to the PTS caused no change in the PTS after medial open-wedge HTO.

scholarly journals Correction to: The effect of the sagittal plane osteotomy inclination on the posterior tibial slope in medial open wedge HTO: experimental study with a square column model

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sang Won Moon ◽  
Ji Young Ryu ◽  
Sung-Jae Lee ◽  
Sang Won Woo ◽  
Sin Hyung Park ◽  
...  
Keyword(s):  
Experimental Study ◽  
Sagittal Plane ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Open Wedge ◽  
Column Model ◽  
Posterior Tibial ◽  
Open Wedge Hto

An amendment to this paper has been published and can be accessed via the original article.

Does Component Alignment Affect Patient Reported Outcomes following Bicruciate Retaining Total Knee Arthroplasty? An In Vivo Three-Dimensional Analysis

2019 ◽  
Vol 33 (08) ◽  
pp. 798-803
Author(s):  
Yun Peng ◽  
Paul Arauz ◽  
Shuai An ◽  
Sakkadech Limmahakhun ◽  
Christian Klemt ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Three Dimensional ◽  
Tibial Slope ◽  
Component Alignment ◽  
Posterior Tibial ◽  
Patient Reported ◽  
Total Knee ◽  
Bcr Tka

AbstractThis is an experimental study. Anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) retaining bicruciate retaining (BCR) total knee arthroplasty (TKA) have the potential to restore normal knee kinematics and thus improve patient outcome. Limited studies have examined the relationship between component alignment and patient-reported outcome measures (PROM). This study aims to determine (1) accurate three-dimensional (3D) component alignment of BCR TKA and (2) whether the component alignment of BCR TKA affects PROMs. The 3D modeling analysis was performed based on computed tomography images from 29 BCR TKAs. Component orientations were quantified for femoral and tibial components in the sagittal, axial, and coronal planes. The knee society scores (KSS) were collected preoperatively and postoperatively at 1-year follow-up. Multiple comparisons were performed to analyze the relationship between component alignment and patient outcomes. High variability was observed in the tibial component alignment (root–mean-square values: axial plane 6.6 degrees, sagittal plane 5.1 degrees, and coronal plane 4.0 degrees). At 1-year follow-up, significant improvement in KSS was noted in BCR TKA patients (p < 0.001). However, regression analysis adjusting for baseline KSS demonstrated the postoperative KSS was negatively associated with the posterior tibial slope (B [slope of the output of the regression analysis] = 2.597, p = 0.006). Patients with greater posterior tibial slopes were reported poorer postoperative functions at 1-year follow-up. Excessive posterior tibial slope may generate greater posterior force on the femur that leads to continuous overloading of the preserved ACL, suggesting optimal sagittal plane alignment of the tibial component may be important for the optimization of postoperative functions of BCR TKA patients.

Three-Dimensional Computed Tomography Analysis of the Posterior Tibial Slope in 100 Knees

2017 ◽  
Vol 32 (10) ◽  
pp. 3176-3183 ◽  
Author(s):  
Jade Pei Yuik Ho ◽  
Azhar M. Merican ◽  
Muhammad Sufian Hashim ◽  
Azlina A. Abbas ◽  
Chee Ken Chan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Three Dimensional ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Tomography Analysis

scholarly journals Total knee arthroplasty: posterior tibial slope influences the size but not the rotational alignment of the tibial component

2020 ◽  
Vol 28 (12) ◽  
pp. 3899-3905
Author(s):  
Petros Ismailidis ◽  
Valerie Kremo ◽  
Annegret Mündermann ◽  
Magdalena Müller-Gerbl ◽  
Andrej Maria Nowakowski
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Tibial Slope ◽  
Rotational Alignment ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Total Knee

scholarly journals Posterior tibial slope and anterior post-cam contact can change knee kinematics in extension in bi-cruciate stabilized total knee arthroplasty

2020 ◽  
Vol 9 (11) ◽  
pp. 761-767
Author(s):  
Masaru Hada ◽  
Hideki Mizu-uchi ◽  
Ken Okazaki ◽  
Koji Murakami ◽  
Takao Kaneko ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Weight Bearing ◽  
Knee Kinematics ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Forward Movement ◽  
Posterior Tibial ◽  
Tibial Insert ◽  
Total Knee

Aims This study aims to investigate the effects of posterior tibial slope (PTS) on knee kinematics involved in the post-cam mechanism in bi-cruciate stabilized (BCS) total knee arthroplasty (TKA) using computer simulation. Methods In total, 11 different PTS (0° to 10°) values were simulated to evaluate the effect of PTS on anterior post-cam contact conditions and knee kinematics in BCS TKA during weight-bearing stair climbing (from 86° to 6° of knee flexion). Knee kinematics were expressed as the lowest points of the medial and lateral femoral condyles on the surface of the tibial insert, and the anteroposterior translation of the femoral component relative to the tibial insert. Results Anterior post-cam contact in BCS TKA was observed with the knee near full extension if PTS was 6° or more. BCS TKA showed a bicondylar roll forward movement from 86° to mid-flexion, and two different patterns from mid-flexion to knee extension: screw home movement without anterior post-cam contact and bicondylar roll forward movement after anterior post-cam contact. Knee kinematics in the simulation showed similar trends to the clinical in vivo data and were almost within the range of inter-specimen variability. Conclusion Postoperative knee kinematics in BCS TKA differed according to PTS and anterior post-cam contact; in particular, anterior post-cam contact changed knee kinematics, which may affect the patient’s perception of the knee during activities. Cite this article: Bone Joint Res 2020;9(11):761–767.

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