Influences of Antero-Posterior Tibial Slope on the Prosthetic Knee Contact Stresses

2016 ◽  
Vol 823 ◽  
pp. 137-142
Author(s):  
Dan Calafeteanu ◽  
Dan Tarnita ◽  
Marius Catana ◽  
Daniel Calin ◽  
Daniela Tarniţă
Keyword(s):  
Knee Prosthesis ◽  
Tibial Slope ◽  
Contact Stresses ◽  
Posterior Tibial Slope ◽  
Human Knee ◽  
Prosthetic Knee ◽  
Posterior Tibial ◽  
Human Knee Joint ◽  
Total Knee ◽  
3D Finite Element Method

In this paper, using 3D finite element method and starting from the virtual model of the human knee joint-prosthesis assembly, we investigate the effects of antero-posterior tibial slope on contact stresses in the three components of total knee prosthesis. Using AnsysWorkbench15.07 software, the stress and displacements maps are obtained for knee-prosthesis assemblies and for their components, considering two loading force: 800N and 2400N and two cases of prosthetic knee varus slope: 176o and b) 191o. For each prosthesis-knee assembly and for each considered force, two variants of antero-posterior tibial slope were considered: 00 and 50.

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

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,

Influence of Posterior Tibial Slope on Kinematics After Cruciate-Retaining Total Knee Arthroplasty

2018 ◽  
Vol 33 (12) ◽  
pp. 3778-3782.e1 ◽  
Author(s):  
Toshitaka Fujito ◽  
Tetsuya Tomita ◽  
Takaharu Yamazaki ◽  
Kosaku Oda ◽  
Hideki Yoshikawa ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Cruciate Retaining ◽  
Posterior Tibial ◽  
Total Knee

scholarly journals Patient-Reported Outcomes with Tibial Baseplate Position and PCL Status in Conforming Total Knee Arthroplast

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Joseph A. Madden, BS ◽  
Payton K. Arnold, MS ◽  
Evan R. Deckard, BSE ◽  
R. Michael Meneghini, MD
Keyword(s):  
Tibial Slope ◽  
Activity Level ◽  
Posterior Tibial Slope ◽  
Consecutive Series ◽  
Posterior Tibial ◽  
Primary Tkas ◽  
Measurement Protocol ◽  
Patient Reported ◽  
Total Knee ◽  
Climbing Stairs

Background and Hypothesis: Anteroposterior (AP) tibial baseplate position, posterior tibial slope, and posterior cruciate ligament (PCL) status in total knee arthroplasty (TKA) undoubtedly affect kinematic patterns. Further, few studies document patient-reported outcome measures (PROMS) in conforming polyethylene TKA with these varying parameters. The purpose of this study was to correlate PROMS with the interaction of AP tibial baseplate position, tibial slope, and PCL status in a consecutive series of primary TKAs with conforming polyethylene. We hypothesized that pain, function, and satisfaction may correlate with a combination of these three parameters. Experimental Design or Project Methods: 589 consecutive primary TKAs of a single implant design performed by a single surgeon between January 2016 and October 2018 were retrospectively reviewed. AP tibial baseplate position (relative to the middle of the tibial canal) and posterior tibial slope measurements were performed on 4-week postoperative sagittal view radiographs with a standardized measurement protocol by two independent blinded raters. Validated PROMS related to activity level, pain, and function were evaluated at minimum one-year. Results: Analyses indicated differences based on ≥8mm vs. <8mm of posterior distance of the tibial baseplate from the tibial canal and whether or not the PCL was released. Four analysis groups (PCL-preserved <8mm, PCL-preserved ≥8mm, PCL-resected <8mm, and PCL-resected ≥8mm) did not differ by demographics/covariates (p≥0.150), tibial slope (p≥0.132), or preoperative PROMS (p≥0.088). The PCL-released <8mm group achieved clinically meaningful higher absolute (92.0) and delta (42.0) median KOOS Jr. scores, higher satisfaction (96.3%), and the greatest reduction in pain while climbing stairs (-7.0) although some findings lacked statistical significance. Conclusion and Potential Impact: In conforming polyethylene TKAs, releasing the PCL in combination with AP tibial baseplate placement <8mm from the tibial canal may eliminate kinematic conflict between the PCL and tibial baseplate leading to improved satisfaction, function, and pain while climbing stairs.

Reproducing the Native Posterior Tibial Slope in Cruciate-Retaining Total Knee Arthroplasty: Technique and Clinical Implications

Orthopedics ◽  
2019 ◽  
Vol 43 (1) ◽  
pp. e21-e26
Author(s):  
James L. Howard ◽  
Mina W. Morcos ◽  
Brent A. Lanting ◽  
Lyndsay E. Somerville ◽  
James P. McAuley
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Clinical Implications ◽  
Cruciate Retaining ◽  
Posterior Tibial ◽  
Total Knee

scholarly journals The usefulness of planning using a preoperative lateral leg image to determine accurate posterior tibial slope in total knee arthroplasty

2019 ◽  
Vol 16 (1) ◽  
pp. 25-30
Author(s):  
Takenori Tomite ◽  
Hidetomo Saito ◽  
Hiroaki Kijima ◽  
Kimio Saito ◽  
Hiroshi Tazawa ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Total Knee

Anatomical References to Assess the Posterior Tibial Slope in Total Knee Arthroplasty: A Comparison of 5 Anatomical Axes

2008 ◽  
Vol 23 (4) ◽  
pp. 586-592 ◽  
Author(s):  
Jae Ho Yoo ◽  
Chong Bum Chang ◽  
Kwang Sook Shin ◽  
Sang Cheol Seong ◽  
Tae Kyun Kim
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Total Knee

scholarly journals The Influence of Posterior Tibial Slope on the Mid-term Clinical Effect of Medial-pivot Knee Prosthesis

2021 ◽  
Author(s):  
Weipeng Shi ◽  
Yaping Jiang ◽  
Xuan Zhao ◽  
Haining Zhang ◽  
Yingzhen Wang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Knee Joint ◽  
Knee Prosthesis ◽  
Tibial Slope ◽  
Joint Line ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Medial Pivot ◽  
Group A ◽  
The Stability

Abstract Objective: To evaluate the effect of posterior tibial slope (PTS) on the mid-term clinical outcome following a medial-pivot (MP) prosthesis. Method: 233 patients from this hospital, who had undergone a total knee arthroplasty (TKA) with MP prosthesis between January 2015 and December 2015, were retrospectively included in this study. They were divided 3 groups according to postoperative PTS: A ≤ 5°; B 5-7° and C ≥ 7°. Multiple assessments were made on the patient postoperatively and recorded in the three groups, the measurements of this study included: The range of motion (ROM), knee scoring system (KSS), Western Ontario and McMaster universities osteoarthritis index (WOMAC), posterior condylar offset (PCO), joint line height and postoperative complications. Results: The average post-operative ROM for groups B and C were 108°and 110°respectively, this was significantly higher than that of group A (98°, P < 0.001). The WOMAC scores of patients in group C were significantly lower than those in groups A and B (p < 0.05). However, there were no significant differences in KSS, PCO, joint line height among the 3 groups (P>0.05). Only 2 cases of postoperative complications occurred in group C, these were recovered after operation. Conclusion: With an increase to PTS, the postoperative ROM can be significantly increased for the patient, however, the knee joint function will not be significantly improved, and the stability of knee joint will not be affected within the appropriate PTS.

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