J Korean Orthop Assoc.  2008 Apr;43(2):207-212. 10.4055/jkoa.2008.43.2.207.

The Change of the Posterior Tibial Slope after Cruciate Retaining Total Knee Arthroplasty

• Bae DK
• Yoon KH
• Song SJ
• Noh JH
• Kim MH

• KMID: 2106441
• DOI: http://doi.org/10.4055/jkoa.2008.43.2.207

Abstract

PURPOSE: To analyze the pre- and postoperative posterior tibial slope angle (PSA) of performing cruciate-retaining total knee arthroplasty (TKA) and to identify the ideal value of the PSA in relation to the clinical results.
MATERIALS AND METHODS
From June 1999 to May 2005, 202 TKA with a NexGen(R) cruciate-retaining knee were performed in 160 patients. The mean follow-up period was 39.8 months. The pre- and postoperative PSA referenced by the proximal tibial medullary canal (PSA-A) and the proximal tibial anterior cortex (PSA-B) were measured by two independent observers. The knee and function scoring system of the American Knee Society and the range of motion of the knee at the last follow-up were evaluated as the clinical results.
RESULTS
The mean PSA-A was 11.4+/-4.8degrees preoperatively and 6.0+/-2.8degrees postoperatively, and the mean PSA-B was 13.6+/-4.9degrees preoperatively and 8.1+/-2.9degrees postoperatively. The difference between the pre- and postoperative PSA increased as the preoperative PSA-A changed from 6.0degrees and the PSA-B changed from 8.1degrees; these findings showed statistical significance based on a simple linear regression (PSA-A: r= 0.837, p=0.000; PSA-B: r=0.834, p=0.000). The knee and function score of American Knee Society improved respectively from 62.9 and 55.8, preoperatively, to 97.4 and 89.7 respectively, at the last follow-up. The range of motion of the knee joint was 128.0degrees preoperatively and 129.7degrees at the last follow-up.
CONCLUSION
In cruciate retaining total knee arthroplasty, PSA-A is mostly distributed within 3.2-8.8degrees, and a reasonable range of PSA-A is 6.0+/-2.8degrees.

Keyword

Knee; Posterior tibial slope; Total knee arthroplasty

MeSH Terms

Arthroplasty
Follow-Up Studies
Humans
Knee
Knee Joint
Linear Models
Range of Motion, Articular

Figure

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  Fig. 1 The measure method of the proximal tibial medullary canal-referenced posterior slope (posterior slope: 90-a). The reference line is the best fit line to 3 points, each of which is the center of the medullary canal just below the tibial tuberosity and at 10 cm and 15 cm distal to the tibial medial plateau.

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  Fig. 2 The measure method of the proximal tibial anterior cortex-referenced posterior slope (posterior slope: 90-a). The reference line is parallel to the anterior cortex below the tibial tuberosity.

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