Alhamdi Hassan, Deroche Etienne, Shatrov Jobe, Batailler Cécile, Lustig Sébastien, Servien Elvire
Orthopaedic Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, 103 grande rue de la Croix Rousse, 69004 Lyon, France.
Sydney Orthopaedic Research Institute, University of Notre Dame Australia, Hornsby and Ku-Ring Hospital, Palmerston Rd, Hornsby NSW 2077, Sydney, Australia.
SICOT J. 2025;11:21. doi: 10.1051/sicotj/2025014. Epub 2025 Mar 27.
The understanding of the influence of posterior tibial slope (PTS) on knee kinematics has increased. However, the PTS influence on clinical outcomes remains unclear. The study aimed to evaluate whether a significant change between the native and the prosthetic tibial plateau PTS influences functional results and the risk of complications following total knee arthroplasty (TKA).
This was a retrospective, monocentric comparative study. Clinical and radiological data from 793 knees were collected from a prospective surgical database. Inclusion criteria were patients operated with a posterior-stabilized TKA (PS-TKA) for primary tibiofemoral osteoarthritis, with or without associated patellofemoral osteoarthritis, or osteonecrosis of the femoral condyle or tibial plateau, with a minimum follow-up of 5 years. Range of motion and International Knee Society (IKS) score as well as radiological measurements were collected preoperatively and postoperatively at each follow-up visit. Two groups were composed according to the change in PTS between pre- and post-op (Group 1: ≤10°, n = 703; Group 2: >10°, n = 90).
The mean follow-up was 75.5 months ± 9.1. The mean change in PTS from preoperative was 4.96° ± 3.24 in group 1 and 12.7° ± 1.87 in group 2. There was no significant difference in the mean IKS Knee subscore (89.5 ± 10.7 and 89.7 ± 10.2, p = 0.89) and mean IKS Function subscore (88.2 ± 15.7 and 86.3 ± 16.6, p = 0.33) in groups 1 and 2, respectively. Postoperative maximum flexion was very satisfactory in both groups with no clinically relevant difference (120.0 ± 11.9 and 123.0 ± 8.3, p = 0.026). The complication rate was 5.0% (n = 40) (5.5% in group 1; 1.1% in group 2; p = 0.07) while the most common complication requiring further procedure was deep infection (n = 9, 1.1%) and the second most common was stiffness (n = 6, 0.8%).
PTS did not influence postoperative maximum flexion or clinical scores and was not associated with a higher complication rate at a minimum 5-year follow-up after PS-TKA.
对胫骨后倾坡度（PTS）对膝关节运动学影响的认识有所增加。然而，PTS对临床结果的影响仍不明确。本研究旨在评估初次全膝关节置换术（TKA）后，天然与人工胫骨平台PTS之间的显著变化是否会影响功能结果及并发症风险。
这是一项回顾性、单中心比较研究。从一个前瞻性手术数据库中收集了793例膝关节的临床和放射学数据。纳入标准为因原发性胫股关节炎接受后稳定型TKA（PS-TKA）手术的患者，伴有或不伴有髌股关节炎，或股骨髁或胫骨平台骨坏死，且至少随访5年。在每次随访时收集术前和术后的活动范围、国际膝关节协会（IKS）评分以及放射学测量数据。根据术前和术后PTS的变化分为两组（第1组：≤10°，n = 703；第2组：>10°，n = 90）。
平均随访时间为75.5个月±9.1个月。第1组术前至术后PTS的平均变化为4.96°±3.24°，第2组为12.7°±1.87°。第1组和第2组的平均IKS膝关节分项评分（89.5±10.7和89.7±10.2，p = 0.89）和平均IKS功能分项评分（88.2±15.7和86.3±16.6，p = 0.33）分别无显著差异。两组术后最大屈曲度均非常令人满意，无临床相关差异（120.0±11.9和123.0±8.3，p = 0.026）。并发症发生率为5.0%（n = 40）（第1组为5.5%；第2组为1.1%；p = 0.07），而需要进一步手术的最常见并发症是深部感染（n = 9，1.1%），第二常见的是关节僵硬（n = 6，0.8%）。
在PS-TKA术后至少5年的随访中，PTS不影响术后最大屈曲度或临床评分，且与较高的并发症发生率无关。
