The biomechanical effect of different posterior tibial slopes on the tibiofemoral joint after posterior-stabilized total knee arthroplasty

• Published in: Journal of orthopaedic surgery and research Vol. 15; no. 1; p. 320
• Main Authors: Wang, Yingpeng, Yan, Songhua, Zeng, Jizhou, Zhang, Kuan
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.08.2020; BioMed Central; BMC
• Subjects: Aged; Arthroplasty (knee); Arthroplasty, Replacement, Knee - methods; Biomechanical Phenomena; Biomechanics; Cadaver; Cadavers; Contact area; Contact pressure; Experiments; Femoral rotation; Femur; Humans; Joint replacement surgery; Joint surgery; Kinematics; Knee; Knee Joint - physiopathology; Knee Joint - surgery; Knee replacement arthroplasty; Male; Middle Aged; Orthopedics; Patient satisfaction; Posterior femoral translation; Posterior tibial slope; Posterior-stabilized total knee arthroplasty; Prostheses; Range of Motion, Articular - physiology; Sensors; Studies; Tibia - physiopathology; Tibia - surgery; Translation; Transplants & implants; China; Posterior tibial slope; Contact pressure; Femoral rotation; Contact area; Posterior-stabilized total knee arthroplasty; Posterior femoral translation
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-020-01851-y

Different posterior tibial slopes (PTS) after posterior-stabilized total knee arthroplasty (PS-TKA) may lead to different biomechanical characteristics of knee joint. This cadaveric study was designed to investigate the tibiofemoral kinematics and contact pressures after PS-TKA with different PTS. Nine human cadaveric knee specimens were used for PS-TKA with the PTS of 3°, 6°, and 9°. The tibiofemoral kinematics and contact pressures were measured during knee flexion angle changing from 0 to 120° (with an increment of 10°) with an axial load of 1000 N at each angle. The root mean square (RMS) of the tibiofemoral contact area and the mean and peak contact pressures during knee flexion were 586.2 mm , 1.85 MPa, and 5.39 MPa before TKA and changed to 130.2 mm , 7.56 MPa, and 17.98 MPa after TKA, respectively. Larger contact area and smaller mean and peak contact pressures were found in the joints with the larger PTS after TKA. The RMS differences of femoral rotation before and after TKA were more than 9.9°. The posterior translation of the lateral condyle with larger PTS was more than that with smaller PTS, while overall, the RMS differences before and after TKA were more than 11.4 mm. After TKA, the tibiofemoral contact area is reduced, and the contact pressure is increased greatly. Approximately 80% of the femoral rotation is lost, and only about 60% of the femoral translation of lateral condyle is recovered. TKA with larger PTS results in more posterior femoral translation, larger contact area, and smaller contact pressure, indicating that with caution, it may be beneficial to properly increase PTS for PS-TKA.