Anterior referencing of tibial slope in total knee arthroplasty considerably influences knee kinematics: a musculoskeletal simulation study

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
Marco A MarraN Verdonschot

Abstract

In total knee arthroplasty (TKA), the posterior tibial slope is not always reconstructed correctly, and the knee ligaments may become too tight in flexion. To release a tight flexion gap, surgeons can increase the posterior tibial slope using two surgical resection techniques: the anterior tibial cortex (ACR) or the centre of tibial plateau (CPR) referencing. It is not known how this choice affects the knee laxity and function during activities of daily living. The aim of this study was to investigate the effect of tibial slope on knee laxity, kinematics and forces during a squatting activity using computer simulation techniques. We hypothesised that the effects depend on the referencing technique utilised. A validated musculoskeletal model of TKA was used. Knee laxity tests were simulated in flexion and extension. Then, a squat motion was simulated to calculate: movement of the tibiofemoral joint (TFJ) contact points and patello-femoral joint (PFJ) contact force. All analyses were repeated with more anterior (-3°), neutral (0°), and more posterior tibial slope (+3°, +6°, +9°), and with two referencing techniques (ACR, CPR). Knee laxities increased dramatically with more posterior slope with the ACR technique (up to 400%), both...Continue Reading

References

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Nov 28, 2014·Journal of Biomechanical Engineering·Marco A MarraMichael S Andersen

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Citations

Apr 7, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Kyoung-Tak KangYong-Gon Koh
Dec 1, 2018·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Joshua D RothMaury L Hull
Feb 25, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Yifei DaiJean-Yves Jenny
Apr 15, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Zhitao RaoGuoan Li
Jul 5, 2019·Der Orthopäde·Silvan WittenbergClemens Gwinner
Nov 30, 2019·Journal of Orthopaedic Surgery and Research·Yong-Gon KohKyoung-Tak Kang
May 25, 2021·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Jong Seop KimHyuk-Soo Han

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