Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, 10 Hyoryeong-ro, Seocho-gu, Seoul 06698, Republic of Korea.
Biomed Res Int. 2018 Jun 11;2018:5139074. doi: 10.1155/2018/5139074. eCollection 2018.
Reconstructed posterior tibial slope (PTS) plays a significant role in kinematics restoration after total knee arthroplasty (TKA). However, the effect of increased and decreased PTS on prosthetic type and design has not yet been investigated. We used a finite element model, validated using in vitro data, to evaluate the effect of PTS on knee kinematics in cruciate-retaining (CR) and posterior-stabilized (PS) fixed TKA and rotating platform mobile-bearing TKA. Anterior-posterior tibial translation and internal-external tibial rotation were investigated for PTS ranging from -3° to 15°, with increments of 1°, for three different designs of TKA. Tibial posterior translation and external rotation increased as the PTS increased in both CR and PS TKAs. In addition, there was no remarkable difference in external rotation between CR and PS TKAs. However, for the mobile-bearing TKA, PTS had less effect on the kinematics. Based on our computational simulation, PTS is the critical factor that influences kinematics in TKA, especially in the CR TKA. Therefore, the surgeon should be careful in choosing the PTS in CR TKAs.
重建后的胫骨后倾角（PTS）在后膝关节置换术（TKA）后恢复运动学中起着重要作用。然而，增加和减少 PTS 对假体类型和设计的影响尚未得到研究。我们使用了有限元模型，该模型使用体外数据进行了验证，以评估 PTS 对前交叉韧带保留型（CR）和后稳定型（PS）固定 TKA 以及旋转平台活动衬垫 TKA 的膝关节运动学的影响。对于三种不同设计的 TKA，我们研究了 PTS 范围从-3°到 15°，步长为 1°时的前后胫骨平移和内外胫骨旋转。在 CR 和 PS TKA 中，胫骨后移和外旋随着 PTS 的增加而增加。此外，CR 和 PS TKA 之间的外旋没有明显差异。然而，对于活动衬垫 TKA，PTS 对运动学的影响较小。基于我们的计算模拟，PTS 是影响 TKA 运动学的关键因素，尤其是在 CR TKA 中。因此，外科医生在选择 CR TKA 中的 PTS 时应小心谨慎。
