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J Knee Surg 2023; 36(01): 087-094
DOI: 10.1055/s-0041-1729967
Original Article

Effect of Posterior Tibial Slope Change on Postoperative Range of Motion and Clinical Outcomes after Posterior Cruciate-Substituting Total Knee Arthroplasty

Authors

  • O-Sung Lee 

    1   Department of Orthopedic Surgery, Eulji University School of Medicine, Uijeongbu-si, Korea (the Republic of)

  • Jangyun Lee

    2   Department of Orthopedic Surgery, National Medical Center, Seoul, Korea (the Republic of)

  • Myung Chul Lee

    3   Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea (the Republic of)

  • Hyuk-Soo Han 

    3   Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea (the Republic of)
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Abstract

The posterior tibial slope (PTS) is usually adjusted by less than 5 degrees, without considering its individual difference, during posterior cruciate-substituting (PS) total knee arthroplasty (TKA). The effect of these individual changes of PTS would be important because clinical results depending on postoperative PTS were reported conflictingly. We investigated the effect of the change in PTS on the postoperative range of motion (ROM) and clinical scores after PS TKA. We retrospectively reviewed 164 knees from 107 patients who underwent PS TKA with a 2-year follow-up. We analyzed the preoperative and postoperative PTS, ROM, visual analog scale pain scale, Western Ontario and McMaster University Index (WOMAC), Hospital for Special Surgery Knee Score, Knee Society Score, and Forgotten Joint Score (FJS). The association of the absolute change in PTS with ROM and clinical scores was analyzed using correlation analysis and multiple regression analysis. As a result, the mean PTS and mean ROM changed from 9.6 ±  3.4 and 120.1 ±  15.4 degrees preoperatively to 2.0 ±  1.3 and 128.4 ±  9.3 degrees postoperatively, and the mean PTS change was 7.6 ±  3.5 degrees. The PTS change had no statistically significant association with the postoperative ROM and clinical scoring systems, although it did have a weak positive correlation with WOMAC function, No 10 (difficulty in rising from sitting) (correlation coefficient = 0.342, p = 0.041), and moderate positive correlation with the FJS, No. 6 (awareness when climbing stairs) (correlation coefficient = 0.470, p = 0.001). The authors concluded that the amount of change in PTS did not affect the postoperative ROM and clinical scores, although proximal tibial resection with a constant target of PTS resulted in individually different changes in the PTS after PS TKA,

Keywords

total knee arthroplasty - posterior tibial slope - range of motion - clinical outcome


Publication History

Received: 27 December 2020

Accepted: 01 April 2021

Article published online:
15 May 2021

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