Effects of posterior tibial slope restoration difference in cruciate retaining total knee arthroplasty using computer-assisted surgery
Keywords:
Osteoarthritis knee, Computer assisted surgery, Total knee arthroplasty, Cruciate retaining, Tibial slopeAbstract
Context: Studies have shown that the presence of a posterior tibial slope after total knee
arthroplasty(TKA), affects both flexion gap balancing and the patient’s range of motion after
surgery, especially in cruciate-retaining, computer-assisted total knee arthroplasty surgery.
Objective: To compare changes in the position of the posterior tibial slope, pre and post
operation, on patients having received CR-TKA (cruciate-retaining total knee arthroplasty). The
effects of a change in the posterior slope on flexion gap balancing and knee bending were
also studied.
Materials and Methods: This was a cross-sectional, retrospective study, performed on computerassisted cruciate-retaining total knee arthroplasty (CAS-CR-TKA) patients at Vajira Hospital, from
February of 2008 to March 31st of 2011. Patients with a degree of knee flexion less than 100
degrees were not included in this study. After performing the CAS-CR-TKA, we classified the
patients into two groups, as determined by comparing the changes in their posterior tibial slope
before and after operation. Changes to the tibial slope were observed via computer and x-ray
film. The study group of patients were those needing to either retain their posterior cruciate
ligament (PCL), needing to change from CAS-CR-TKA to PS-TKA (posterior stabilized-TKA); or,
whose degree of knee bending was less than 15 degrees. The control group of patients were
those with an equal or improved degree of knee flexion before taking their CAS-CR-TKA.
Results: Slope restoration differences between the study and control groups were statistically
significant (7.64 degrees in the study group, and 4.16 degrees in the control group) with p-value
at 0.01. The pre and postoperative posterior tibial slope was not different statistically between
Conclusions: Posterior tibial slope restoration (changing between pre-operative and postoperative tibial slope) greater than 7.64 degrees will result in inability to find a balance gap
during knee flexion and decrease range of motion of the knee after the cruciate-retaining,
computer-assisted total knee arthroplasty surgery.
groups.
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