Effect of tibial slope changes on femorotibial contact kinematics after cruciate-retaining total knee arthroplasty.

PURPOSE

The present study was undertaken to evaluate the effect of tibial slope (TS) changes on the femorotibial articular contact kinematics in subjects undergoing posterior cruciate-retaining total knee arthroplasty (CRTKA).

METHODS

Eighteen knees in nine patients with medial osteoarthritis who underwent CRTKA using the same size prosthesis were analysed preoperatively and 2 years after TKA. TS changes were calculated on lateral radiographs taken before and after TKA. Knees were classified into two groups according to the change in TS obtained by subtracting the post-operative value from the preoperative value: group 1 (>3°) and group 2 (<3°). The femorotibial articular contact kinematics of knees during weight-bearing flexion were compared between the two groups by two-dimensional/three-dimensional registration.

RESULTS

Group 1 showed a continuous posterior translation of the medial femoral condyle during the process of knee flexion, whereas in group 2 the medial femoral condyle experienced paradoxical anterior motion from 20° to 90° of knee flexion. The lateral femoral condyle continuously moved posteriorly in both groups.

CONCLUSION

A greater reduction in TS after TKA compared with preoperative TS reduces paradoxical medial femoral condylar movement. This may contribute to improved patient satisfaction after CR TKA.

LEVEL OF EVIDENCE

III.