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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 26, Issue 10, pp 3188–3195 | Cite as

The increase in posterior tibial slope provides a positive biomechanical effect in posterior-stabilized total knee arthroplasty

  • Kyoung-Tak Kang
  • Sae Kwang Kwon
  • Juhyun Son
  • Oh-Ryong Kwon
  • Jun-Sang Lee
  • Yong-Gon Koh
Knee

Abstract

Purpose

This study aims to clarify the influence of the posterior tibial slope (PTS) on knee joint biomechanics after posterior-stabilized (PS) total knee arthroplasty (TKA) using a computer simulation.

Methods

A validated TKA computational model was used to evaluate and quantify the effects of an increased PTS. In order to conduct a squat simulation, models with a − 3° to 15° PTS using increments of 3° were developed. Forces on the quadriceps and collateral ligament, a tibial posterior translation, contact point on a polyethylene (PE) insert, and contact stress on the patellofemoral (PF) joint and post in a PE insert were compared.

Results

The maximum force on the quadriceps and the PF contact stress decreased with increases in the PTS. The kinematics on the tibiofemoral (TF) joint translated in an increasingly posterior manner, and the medial and lateral contact points on a PE insert were located in posterior regions with increases in the PTS. Additionally, increases in the PTS decreased the force on the collateral ligament and increased the contact stress on the post in a PE insert. A higher force on the quadriceps is required when the PTS decreases with an equivalent flexion angle.

Conclusions

A surgeon should be prudent in terms of determining the PTS because an excessive increase in the PTS may lead to the progressive loosening of the TF joint due to a reduction in collateral ligament tension and failure of the post in a PE insert. Thus, we support a more individualized approach of optimal PTS determination given the findings of the study.

Keywords

Posterior tibial slope Total knee arthroplasty Kinematics 

Notes

Funding

There was no funding for this study.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

Approval was not required, as neither human participants nor animals were involved in this study.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Kyoung-Tak Kang
    • 1
  • Sae Kwang Kwon
    • 2
  • Juhyun Son
    • 1
  • Oh-Ryong Kwon
    • 2
  • Jun-Sang Lee
    • 2
  • Yong-Gon Koh
    • 2
  1. 1.Department of Mechanical EngineeringYonsei UniversitySeoulRepublic of Korea
  2. 2.Department of Orthopaedic Surgery, Joint Reconstruction CenterYonsei Sarang HospitalSeoulRepublic of Korea

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