"Effect of Posterior Tibial Slope on Postoperative Flexion and Functional Outcome in Total Knee Arthroplasty. A Double Blinded Randomised Controlled Trial"

Aja Santini

doi:10.26717/bjstr.2021.35.005719

Abstract

N Howard1, C Jakaraddi1, JR Fountain1, JA Pope1, JS Davidson1, D Patel1 and AJA Santini1,2* Author Affiliations 1The Lower Limb Unit, Department of Orthopaedics, Liverpool University Hospitals NHS Foundation Trust, England 2Faculty of Life and health Sciences, The University of Liverpool, England Received: April 19, 2021 | Published: May 04, 2021 Corresponding author: AJA Santini, Lower Limb Unit, Department of Orthopaedics, Broadgreen Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England DOI: 10.26717/BJSTR.2021.35.005719

Highlights

No significant difference in either range of movement or quality of life measurements were found at any time point between the 0 ̊ and 4 ̊ groups. This in vivo study has shown no correlation with flexion or outcome scores between two posterior tibial slopes in a cruciate retaining arthroplasty
Total knee arthroplasty is a well-established treatment for degenerative knee conditions
Because the flexion gap and range of movement are influenced by many factors in addition to the tibial slope, including posterior cruciate ligament tension, femoral component size and quadriceps tightness, it is difficult to analyse the effect of the slope using retrospective case series

Summary

Background

A posterior tibial slope in total knee arthroplasty may improve femoral roll-back, providing more normal knee kinematics and increased flexion. The roll-back mechanism is complex and not fully replicated in modern arthroplasties, a posterior slope reduces the height of the posterior tibial wall. Contact between the posterior tibia and posterior femur occurs later in the range of flexion which should in theory maximize flexion. Clinical trials far have shown little difference between knee replacements using varying tibial slope values. Most such trials have been retrospective case series

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