Dataset Information

The posterior tibial slope does not influence the flexion angle in posterior-stabilized mobile-bearing total knee arthroplasty.

ABSTRACT:

Background

It remains uncertain whether an increase in the tibial slope leads to better flexion in posterior-stabilized (PS) total knee prostheses.

Purpose

To compare the intra-operative flexion angle between standard and an additional 10° posterior slope inserts.

Patients and methods

Between December 2014 and February 2015, 22 patients (25 knees) who underwent PS mobile-bearing primary total knee arthroplasty (TKA) were included. Flexion angles were measured using either standard or specially-made inserts. Differences in flexion angles between the two situations were analyzed to determine the relationship between changes in flexion angle and pre-operative flexion angle or body mass index (BMI), and between intra- and post-operative flexion angle.

Results

The difference between the average flexion angle of standard inserts and specially-made inserts was not statistically significant. Although the correlations between changes in flexion angle due to insert difference and flexion angle, pre-operative flexion angle or BMI were not significant, there was a positive correlation between intra-operative and post-operative flexion at 2 years.

Conclusion

The results showed an additional posterior tibial slope by 10° did not affect the intra-operative flexion angle. Surgeons performing PS mobile-bearing TKA do not need to excessively slope the tibial bone cutting to improve the post-operative flexion angle.

Level of evidence

I, Experimental study.

SUBMITTER: Takemura S

PROVIDER: S-EPMC8796609 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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Publications

The posterior tibial slope does not influence the flexion angle in posterior-stabilized mobile-bearing total knee arthroplasty.

Takemura Susumu S Ikawa Tessyu T Ohyama Yohei Y Kim Mitsunari M Takaoka Kunio K Minoda Yukihide Y Kadoya Yoshinori Y

Arthroplasty (London, England) 20210802 1

<h4>Background</h4>It remains uncertain whether an increase in the tibial slope leads to better flexion in posterior-stabilized (PS) total knee prostheses.<h4>Purpose</h4>To compare the intra-operative flexion angle between standard and an additional 10° posterior slope inserts.<h4>Patients and methods</h4>Between December 2014 and February 2015, 22 patients (25 knees) who underwent PS mobile-bearing primary total knee arthroplasty (TKA) were included. Flexion angles were measured using either s ...[more]

PMID: 35236482

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Project description:BackgroundIn medial mobile-bearing unicompartmental knee arthroplasty (MB-UKA), the position of the bearing does not correspond to the planned position which will increasing the risk of bearing dislocation. This study aimed to explore the relationship between the malposition of the femoral and tibial components and the phenomenon of bearing deviation using postoperative radiological measurements.MethodsOne hundred twenty patients who underwent mobile-bearing uni-compartmental knee arthroplasty (MB-UKA) at our hospital between January and August 2023 were enrolled in this retrospective study. Standard anteroposterior radiographs were obtained postoperatively using C-arm fluoroscopy. A 3D-2D image matching method was used to measure the femoral component varus/valgus angle and internal/external rotation (IR/ER) relative to the tibial component. The bearing position parameters were measured. Patients were divided into varus/valgus and IR/ER groups according to the femoral component varus/valgus and IR/ER angles. The bearing position parameters of each group were compared separately.ResultsThere were 57 patients in the varus group, 63 in the valgus group, 59 in the IR group, and 61 in the ER group. The distance between the bearing lateral edge and the lateral wall of the tibial component (W-BED) was significantly lower in the varus group than the valgus group (1.9 [0-6.4] vs. 2.8 [0.3-7.7] mm; P < 0.001). No differences were detected in any bearing position parameters. The varus/valgus angle of the femoral component showed a significant negative correlation with the W-BED. The IR/ER angle of the femoral component showed no significant correlation with any of the positional parameters.ConclusionsImplantation of femoral component with varus/valgus angle relative to tibial component can cause the bearing to deviate from the planned position. If the varus/valgus angle exceeds 8° it can cause the bearing to hit or away from the lateral wall of the tibial component, resulting in an increased risk of dislocation of the bearing.

Project description:BackgroundThe controversy regarding the outcome of total knee arthroplasties after high tibial osteotomy may relate to malalignment secondary to overcorrection after high tibial osteotomy (HTO) [1, 2] and to the type of arthroplasty itself (posterior-stabilized arthroplasty or posterior cruciate ligament-retaining prosthesis).Questions/purposeWe asked two questions: (1) Would a posterior-stabilized arthroplasty provide sufficient constrain and improve pain and function in patients with severe malalignment due to a previous HTO? (2) Will malalignment of the previous HTO jeopardize the long-term results of a total knee reconstruction with a posterior-stabilized implant?Patients and methodsWe retrospectively reviewed 25 posterior-stabilized TKAs in 25 patients with severe valgus deformity after HTO (ranging from 10° to 20° of valgus) and compared the results with a series of matched 25 posterior-stabilized TKAs in 25 patients with normocorrection after HTO ranging from 5° of valgus to 5° of varus. Clinical, operative, and radiographic data were reviewed. Minimum follow-up was 10 years after the arthroplasty (average, 15 years; range, 10-20 years).ResultsAll the knees had standard posterior-stabilized total knee arthroplasty implants. Patients with an overcorrected HTO were more likely to require a soft tissue release to balance the knee. However, Average Knee Society and Function Score improved, respectively, from 48 to 85 and from 50 to 90 points in the severely overcorrected group, versus, respectively, 50 to 89 and 52 to 97 in the normocorrected group, but the range of mobility was superior for patients with normal alignment. Fifteen-year survivorship after the arthroplasty comparison showed no significant difference between the two groups (one revision in each group).ConclusionsPatients with an overcorrected HTO are more likely to require a soft tissue release to balance the knee. However, both groups show improvements in function and pain. With a posterior-stabilized arthroplasty, the degree of deformity has no impact on the longevity of the TKA.

Dataset Information

The posterior tibial slope does not influence the flexion angle in posterior-stabilized mobile-bearing total knee arthroplasty.

Background

Purpose

Patients and methods

Results

Conclusion

Level of evidence

Publications

The posterior tibial slope does not influence the flexion angle in posterior-stabilized mobile-bearing total knee arthroplasty.

Similar Datasets

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