title: Effect of Posterior Tibial Slope on Flexion and Anterior-Posterior Tibial Translation in Posterior Cruciate-Retaining Total Knee Arthroplasty.
abstract: Reduced posterior tibial slope (PTS) and posterior tibiofemoral translation (PTFT) in posterior cruciate-retaining (PCR) total knee arthroplasty (TKA) may result in suboptimal flexion. We evaluated the relationship between PTS, PTFT, and total knee flexion after PCR TKA in a cadaveric model. We performed a balanced PCR TKA using 9 transfemoral cadaver specimens and changed postoperative PTS in 1° increments. We measured maximal flexion and relative PTFT at maximal flexion. We determined significant changes in flexion and PTFT as a function of PTS. Findings showed an average increase in flexion of 2.3° and average PTFT increase of 1mm per degree of PTS increase when increasing PTS from 1° to 4° (P<.05). Small initial increases in PTS appear to significantly increase knee flexion and PTFT.
authors.affiliation: Department of Orthopaedic Surgery, John Peter Smith Health Network, Fort Worth, Texas; Department of Orthopaedic Surgery, University of North Texas Health Science Center, Fort Worth, Texas.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Chambers
authors.affiliation: Department of Orthopaedic Surgery, University of North Texas Health Science Center, Fort Worth, Texas.
authors.forename: Addison R
authors.initials: AR
authors.lastname: Wood
authors.affiliation: Department of Orthopaedic Surgery, University of North Texas Health Science Center, Fort Worth, Texas; Department of Materials Science and Engineering, University of North Texas, Denton, Texas.
authors.forename: Victor
authors.initials: V
authors.lastname: Kosmopoulos
authors.affiliation: Department of Orthopaedic Surgery, John Peter Smith Health Network, Fort Worth, Texas; Department of Orthopaedic Surgery, University of North Texas Health Science Center, Fort Worth, Texas.
authors.forename: Hugo B
authors.initials: HB
authors.lastname: Sanchez
authors.affiliation: Department of Orthopaedic Surgery, John Peter Smith Health Network, Fort Worth, Texas; Department of Orthopaedic Surgery, University of North Texas Health Science Center, Fort Worth, Texas.
authors.forename: Russell A
authors.initials: RA
authors.lastname: Wagner
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D009068:Movement; D018482:Muscle, Skeletal / Q000502:physiology; D009985:Orthopedics / Q000379:methods; D016119:Posterior Cruciate Ligament / Q000601:surgery; D011184:Postoperative Period; D016059:Range of Motion, Articular; D013977:Tibia / Q000033:anatomy & histology* / Q000601:surgery*
keywords: maximum flexion; posterior tibial slope; posterior tibial translation; primary knee arthroplasty; tibiofemoral translation; total knee replacement