Ken Okazaki1, Yasutaka Tashiro2, Hideki Mizu-uchi2, Satoshi Hamai2, Toshio Doi2, Yukihide Iwamoto2. 1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Electronic address: okazaki@med.kyushu-u.ac.jp. 2. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Abstract
BACKGROUND: Adjusting the joint gap length to be equal in both extension and flexion is an important issue in total knee arthroplasty (TKA). It is generally acknowledged that posterior tibial slope affects the flexion gap; however, the extent to which changes in the tibial slope angle directly affect the flexion gap remains unclear. This study aimed to clarify the influence of tibial slope changes on the flexion gap in cruciate-retaining (CR) or posterior-stabilizing (PS) TKA. METHODS: The flexion gap was measured using a tensor device with the femoral trial component in 20 cases each of CR- and PS-TKA. A wedge plate with a 5° inclination was placed on the tibial cut surface by switching its front-back direction to increase or decrease the tibial slope by 5°. The flexion gap after changing the tibial slope was compared to that of the neutral slope measured with a flat plate that had the same thickness as that of the wedge plate center. RESULTS: When the tibial slope decreased or increased by 5°, the flexion gap decreased or increased by 1.9 ± 0.6mm or 1.8 ± 0.4mm, respectively, with CR-TKA and 1.2 ± 0.4mm or 1.1 ± 0.3mm, respectively, with PS-TKA. CONCLUSIONS: The influence of changing the tibial slope by 5° on the flexion gap was approximately 2mm with CR-TKA and 1mm with PS-TKA. CLINICAL RELEVANCE: This information is useful when considering the effect of manipulating the tibial slope on the flexion gap when performing CR- or PS-TKA.
BACKGROUND: Adjusting the joint gap length to be equal in both extension and flexion is an important issue in total knee arthroplasty (TKA). It is generally acknowledged that posterior tibial slope affects the flexion gap; however, the extent to which changes in the tibial slope angle directly affect the flexion gap remains unclear. This study aimed to clarify the influence of tibial slope changes on the flexion gap in cruciate-retaining (CR) or posterior-stabilizing (PS) TKA. METHODS: The flexion gap was measured using a tensor device with the femoral trial component in 20 cases each of CR- and PS-TKA. A wedge plate with a 5° inclination was placed on the tibial cut surface by switching its front-back direction to increase or decrease the tibial slope by 5°. The flexion gap after changing the tibial slope was compared to that of the neutral slope measured with a flat plate that had the same thickness as that of the wedge plate center. RESULTS: When the tibial slope decreased or increased by 5°, the flexion gap decreased or increased by 1.9 ± 0.6mm or 1.8 ± 0.4mm, respectively, with CR-TKA and 1.2 ± 0.4mm or 1.1 ± 0.3mm, respectively, with PS-TKA. CONCLUSIONS: The influence of changing the tibial slope by 5° on the flexion gap was approximately 2mm with CR-TKA and 1mm with PS-TKA. CLINICAL RELEVANCE: This information is useful when considering the effect of manipulating the tibial slope on the flexion gap when performing CR- or PS-TKA.
Authors: Kaushik Hazratwala; William B O'Callaghan; Shilpa Dhariwal; Matthew P R Wilkinson Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-09-06 Impact factor: 4.114
Authors: Robin Pourzal; Johannes Cip; Elmira Rad; Michel P Laurent; Richard A Berger; Joshua J Jacobs; Markus A Wimmer Journal: J Orthop Res Date: 2020-05-25 Impact factor: 3.494
Authors: Marco A Marra; Marta Strzelczak; Petra J C Heesterbeek; Sebastiaan A W van de Groes; Dennis W Janssen; Bart F J M Koopman; Ate B Wymenga; Nico J J Verdonschot Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-05-12 Impact factor: 4.342
Authors: M Kebbach; R Grawe; A Geier; E Winter; P Bergschmidt; D Kluess; D D'Lima; C Woernle; R Bader Journal: Sci Rep Date: 2019-10-10 Impact factor: 4.379
Authors: David Williams; Andrew Metcalfe; June Madete; Gemma Whatling; Peter Kempshall; Mark Forster; Kathleen Lyons; Cathy Holt Journal: J Biomech Date: 2020-09-11 Impact factor: 2.712