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Published in: International Orthopaedics 2/2014

01-02-2014 | Original Paper

Impact of the tibial slope on range of motion after low-contact-stress, mobile-bearing, total knee arthroplasty

Authors: Norbert Kastner, Simon Sternbauer, Jörg Friesenbichler, Ines Vielgut, Matthias Wolf, Mathias Glehr, Andreas Leithner, Patrick Sadoghi

Published in: International Orthopaedics | Issue 2/2014

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Abstract

Purpose

The aim of this study was to analyse a possible correlation between the tibial slope and range of motion (ROM) after implantation of the low-contact-stress (LCS), mobile-bearing, total knee arthroplasty (TKA) after a minimum follow-up of ten years.

Methods

Eighty-three TKAs in 66 patients were investigated in this retrospective correlation analysis at a minimum follow up of ten years. Out of these 66 patients, 50 were women (76 %) and 16 (24 %) were men. The average age of these patients at the time of the examination was 76 years [standard deviation (SD) 11 years, range 37–95 years]. A lateral X-ray was taken at follow-up in order to analyse the tibial slope with respect to inter- and intra-observer agreement. ROM was measured and correlated with the tibial slope.

Results

The mean active ROM was 96.1° (SD 18.8) and the mean tibial slope after four measurements was 7.65° (SD 4.23), with substantial inter- and intra-observer agreement. We found no significant correlation between tibial slope and ROM in patients with a minimum follow-up of ten years [correlation 0.196 (p > 0.05) and 0.152, (p > 0.05), respectively].

Conclusions

Alteration of the tibial slope does not significantly influence ROM after implantation of the LCS TKA at a minimum follow-up of ten years. We conclude that the tibial slope is not the primary influencing factor for ROM in patients ten years after primary TKA and believe that it should not substantially be altered during surgery.
Literature
1.
go back to reference Agneskirchner JD, Hurschler C, Stukenborg-Colsman C, Imhoff AB, Lobenhoffer P (2004) Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees. Winner of the AGA-DonJoy Award 2004. Arch Orthop Trauma Surg 124:575–584PubMedCrossRef Agneskirchner JD, Hurschler C, Stukenborg-Colsman C, Imhoff AB, Lobenhoffer P (2004) Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees. Winner of the AGA-DonJoy Award 2004. Arch Orthop Trauma Surg 124:575–584PubMedCrossRef
2.
go back to reference Aigner C, Windhager R, Pechmann M, Rehak P, Engeleke K (2004) The influence of an anterior-posterior gliding mobile bearing on range of motion after total knee arthroplasty. A prospective, randomized, double-blinded study. J Bone Joint Surg Am 86:2257–2262PubMed Aigner C, Windhager R, Pechmann M, Rehak P, Engeleke K (2004) The influence of an anterior-posterior gliding mobile bearing on range of motion after total knee arthroplasty. A prospective, randomized, double-blinded study. J Bone Joint Surg Am 86:2257–2262PubMed
3.
go back to reference Bellemans J, Robijns F, Duerinckx J, Banks S, Vandenneucker H (2005) The influence of tibial slope on maximal flexion after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 13:193–196PubMedCrossRef Bellemans J, Robijns F, Duerinckx J, Banks S, Vandenneucker H (2005) The influence of tibial slope on maximal flexion after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 13:193–196PubMedCrossRef
4.
go back to reference Bourne R, Mukhi S (2007) Role of obesity on the risk for total hip or knee arthroplasty. Clin Orthop Relat Res 465:185–188PubMed Bourne R, Mukhi S (2007) Role of obesity on the risk for total hip or knee arthroplasty. Clin Orthop Relat Res 465:185–188PubMed
5.
go back to reference Carr AJ, Robertsson O, Graves S, Price AJ, Arden NK, Judge A et al (2010) Knee replacement. Lancet 379:1331–1340CrossRef Carr AJ, Robertsson O, Graves S, Price AJ, Arden NK, Judge A et al (2010) Knee replacement. Lancet 379:1331–1340CrossRef
6.
go back to reference De Boer JJ, Blankevoort L, Kingma I, Vorster W (2009) In vitro study of inter-individual variation in posterior slope in the knee joint. Clinical Biomechanics 6:488–492CrossRef De Boer JJ, Blankevoort L, Kingma I, Vorster W (2009) In vitro study of inter-individual variation in posterior slope in the knee joint. Clinical Biomechanics 6:488–492CrossRef
7.
go back to reference Giffin JR, Stabile KJ, Zantop T, Vogrin TM, Woo SL, Harner CD (2007) Importance of tibial slope for stability of the posterior cruciate ligament deficient knee. Am J Sports Med 35:1443–1449PubMedCrossRef Giffin JR, Stabile KJ, Zantop T, Vogrin TM, Woo SL, Harner CD (2007) Importance of tibial slope for stability of the posterior cruciate ligament deficient knee. Am J Sports Med 35:1443–1449PubMedCrossRef
8.
go back to reference Han HS, Chang CB, Seong SC, Lee S, Lee MC (2008) Evaluation of anatomic references for tibial sagittal alignment in total kneearthroplasty. Knee Surg Sports Traumatol Arthrosc 16:373–377PubMedCrossRef Han HS, Chang CB, Seong SC, Lee S, Lee MC (2008) Evaluation of anatomic references for tibial sagittal alignment in total kneearthroplasty. Knee Surg Sports Traumatol Arthrosc 16:373–377PubMedCrossRef
9.
go back to reference Hofmann AA, Bachus KN, Wyatt RW (1991) Effect of the tibial cut on subsidence following total knee arthroplasty. Clin Orthop Relat Res 269:63–69PubMed Hofmann AA, Bachus KN, Wyatt RW (1991) Effect of the tibial cut on subsidence following total knee arthroplasty. Clin Orthop Relat Res 269:63–69PubMed
10.
go back to reference Kastner N, Gruber G, Aigner BA, Friesenbichler J, Pechmann M, Fürst F, Vavken P, Leithner A, Sadoghi P (2012) Sex-related outcome differences after implantation of low-contact stress mobile-bearing total knee arthroplasty. Int Orthop 36:1393–1397PubMedCentralPubMedCrossRef Kastner N, Gruber G, Aigner BA, Friesenbichler J, Pechmann M, Fürst F, Vavken P, Leithner A, Sadoghi P (2012) Sex-related outcome differences after implantation of low-contact stress mobile-bearing total knee arthroplasty. Int Orthop 36:1393–1397PubMedCentralPubMedCrossRef
11.
go back to reference Kastner N, Gruber G, Sadoghi P (2012) Can we always trust in the computer? Adequate tibial alignment and flexion-gap balancing using personalised knee arthroplasty cutting blocks. Int Orthop 36:2395PubMedCentralPubMedCrossRef Kastner N, Gruber G, Sadoghi P (2012) Can we always trust in the computer? Adequate tibial alignment and flexion-gap balancing using personalised knee arthroplasty cutting blocks. Int Orthop 36:2395PubMedCentralPubMedCrossRef
12.
go back to reference Kennedy JW, Johnston L, Cochrane L, Boscainos PJ (2013) Total knee arthroplasty in the elderly: Does age affect pain, function or complications? Clinical Orthopaedics and Related Research® [Internet]. 2013 Jan 25 [cited 2013 Mar 11] Kennedy JW, Johnston L, Cochrane L, Boscainos PJ (2013) Total knee arthroplasty in the elderly: Does age affect pain, function or complications? Clinical Orthopaedics and Related Research® [Internet]. 2013 Jan 25 [cited 2013 Mar 11]
14.
go back to reference Sadoghi P, Liebensteiner M, Agreiter M, Leithner A, Böhler N, Labek G (2013) Revision surgery after total joint arthroplasty: A complication-based analysis using worldwide arthroplasty registers. J Arthroplasty. doi:10.1016/j.arth.2013.01.012, [Epub ahead of print] Sadoghi P, Liebensteiner M, Agreiter M, Leithner A, Böhler N, Labek G (2013) Revision surgery after total joint arthroplasty: A complication-based analysis using worldwide arthroplasty registers. J Arthroplasty. doi:10.​1016/​j.​arth.​2013.​01.​012, [Epub ahead of print]
15.
go back to reference Seo SS, Kim CW, Kim JH, Min YK (2013) Clinical Results Associated with Changes of Posterior Tibial Slope in Total Knee Arthroplasty. Knee Surg Relat Res 25:25PubMedCentralPubMedCrossRef Seo SS, Kim CW, Kim JH, Min YK (2013) Clinical Results Associated with Changes of Posterior Tibial Slope in Total Knee Arthroplasty. Knee Surg Relat Res 25:25PubMedCentralPubMedCrossRef
16.
go back to reference Todd MS, Laliss S, Garcia E, DeBerardino TM, Cameron KL (2010) The Relationship Between Posterior Tibial Slope and Anterior Crucitae Ligament Injuries. Am J Sports Med 38(1):63–67PubMedCrossRef Todd MS, Laliss S, Garcia E, DeBerardino TM, Cameron KL (2010) The Relationship Between Posterior Tibial Slope and Anterior Crucitae Ligament Injuries. Am J Sports Med 38(1):63–67PubMedCrossRef
17.
go back to reference Utzschneider S, Goettinger M, Weber P, Horng A, Glaser C, Jansson V et al (2011) Development and validation of a new method for the radiologic measurement of the tibial slope. Knee Surg Sports Traumatol Arthrosc 19:1643–1648PubMedCrossRef Utzschneider S, Goettinger M, Weber P, Horng A, Glaser C, Jansson V et al (2011) Development and validation of a new method for the radiologic measurement of the tibial slope. Knee Surg Sports Traumatol Arthrosc 19:1643–1648PubMedCrossRef
18.
go back to reference Vasarhelyi EM, MacDonald SJ (2012) The influence of obesity on total joint arthroplasty. Journal of Bone and Joint Surgery - British 94-B(11_Supple_A):100–102CrossRef Vasarhelyi EM, MacDonald SJ (2012) The influence of obesity on total joint arthroplasty. Journal of Bone and Joint Surgery - British 94-B(11_Supple_A):100–102CrossRef
19.
go back to reference Whiteside LA, Amador DD (1988) The effect of posterior tibial slope on knee stability after Ortholoc total knee arthroplasty. J Arthroplasty 3(Suppl):S51–S57PubMedCrossRef Whiteside LA, Amador DD (1988) The effect of posterior tibial slope on knee stability after Ortholoc total knee arthroplasty. J Arthroplasty 3(Suppl):S51–S57PubMedCrossRef
20.
go back to reference Winiarsky R, Barth P, Lotke P (1998) Total knee arthroplasty in morbidly obese patients. J Bone Joint Surg 80:1770–1774PubMed Winiarsky R, Barth P, Lotke P (1998) Total knee arthroplasty in morbidly obese patients. J Bone Joint Surg 80:1770–1774PubMed
24.
go back to reference Yoo JH, Chang CB, Shin KS, Seong SC, Kim TK (2008) Anatomical references to assess the posterior tibial slope in total knee arthroplasty: A comparison of 5 anatomical axes. J Arthroplasty 23:586–592PubMedCrossRef Yoo JH, Chang CB, Shin KS, Seong SC, Kim TK (2008) Anatomical references to assess the posterior tibial slope in total knee arthroplasty: A comparison of 5 anatomical axes. J Arthroplasty 23:586–592PubMedCrossRef
Metadata
Title
Impact of the tibial slope on range of motion after low-contact-stress, mobile-bearing, total knee arthroplasty
Authors
Norbert Kastner
Simon Sternbauer
Jörg Friesenbichler
Ines Vielgut
Matthias Wolf
Mathias Glehr
Andreas Leithner
Patrick Sadoghi
Publication date
01-02-2014
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 2/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-2242-5

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