The Relationship Between Posterior Tibial Slope and Knee Range of Movements in Posterior Stabilized Total Knee Replacement: A Navigation-Assisted Analysis of 120 Cases.

Abstract

Background Posterior tibial slope (PTS) is one of the factors that determine the postoperative range of movement (ROM) in total knee replacement (TKR). While biomechanical factors influencing ROM such as PTS, soft-tissue balancing, and choice of implants are surgeon-dependent, non-biomechanical factors such as physiotherapy and pain are subjective and beyond the surgeon's control. Using navigation, we avoided these factors and objectively correlated the difference in PTS with ROM. Methodology A total of 120 cases of posteriorly stabilized (PS) TKR were included. The X-ray-measured difference in PTS was compared to the corresponding change in the ROM intraoperatively using the TKR navigation system. Based on the change in PTS, the cases were classified into three groups, and the intergroup variability of mean postoperative ROM, mediolateral laxity difference (MLD), and residual flexion (RF) was calculated. Results An average MLD of 1.39 mm in extension and 1.79 mm in flexion and an average RF of 3.18 degrees were seen. This uniformity neutralizes the effects of these factors on the ROM. The mean difference in the PTS in the three groups was 4.45, 10.76, and 17.98 degrees, and the mean change in the ROM was 3.07, 1.47, and 2.84 degrees, respectively. There was no statistically significant change in ROM with that of change in PTS. Conclusions In our study, it was shown statistically that the coronal and sagittal planes were uniformly balanced using navigation assistance, and the PTS and the postoperative ROM were the only variables. The correlated results showed that a change in the PTS does not affect the postoperative ROM in PS TKR using the implant system used in our study.