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J Knee Surg 2024; 37(04): 316-325
DOI: 10.1055/a-2094-8967
Original Article

Increase in the Posterior Tibial Slope Provides Better Joint Awareness and Patient Satisfaction in Cruciate-Retaining Total Knee Arthroplasty

Hiroyasu Ogawa
1   Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
2   Department of Orthopaedic Surgery, Ogaki Tokushukai Hospital, Ogaki, Gifu, Japan
,
Masaya Sengoku
2   Department of Orthopaedic Surgery, Ogaki Tokushukai Hospital, Ogaki, Gifu, Japan
,
Yutaka Nakamura
2   Department of Orthopaedic Surgery, Ogaki Tokushukai Hospital, Ogaki, Gifu, Japan
,
Tetsuya Shimokawa
2   Department of Orthopaedic Surgery, Ogaki Tokushukai Hospital, Ogaki, Gifu, Japan
,
Kazuichiro Ohnishi
2   Department of Orthopaedic Surgery, Ogaki Tokushukai Hospital, Ogaki, Gifu, Japan
,
Haruhiko Akiyama
1   Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
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Abstract

The effect of the posterior tibial slope (PTS) in cruciate-retaining total knee arthroplasty (CR-TKA) on clinical outcomes remains unclear. We aimed to investigate (1) the effect of alteration of the PTS on clinical outcomes, including patient satisfaction and joint awareness, and (2) the relationship between the patient-reported outcomes, the PTS, and compartment loading. Based on the alteration of the PTS after CR-TKA, 39 and 16 patients were stratified into increased and decreased PTS groups, respectively. Clinical evaluation was performed by the Knee Society Score (KSS) 2011 and the Forgotten Joint Score-12 (FJS-12). Compartment loading was intraoperatively assessed. KSS 2011 (symptoms, satisfaction, and total score) was significantly higher (p = 0.018, 0.023, and 0.040, respectively), and FJS (“climbing stairs?”) was significantly lower (p = 0.025) in the increased PTS group compared with the decreased PTS group. The decrease in both medial and lateral compartment loading of Δ45°, Δ90°, and ΔFull was significantly greater in the increased PTS group than in the decreased PTS group (p< 0.01 for both comparisons). Medial compartment loading of Δ45°, Δ90°, and ΔFull significantly correlated with KSS 2011 for “symptom” (r = − 0.4042, −0.4164, and −0.4010, respectively; p = 0.0267, 0.0246, and 0.0311, respectively). ΔPTS significantly correlated with medial compartment loading differentials of Δ45°, Δ90°, and ΔFull (r = − 0.3288, −0.3792, and −0.4424, respectively; p = 0.0358, 0.01558, and 0.0043, respectively). Patients with increased PTS showed better symptoms and higher patient satisfaction compared with those with decreased PTS following CR-TKA, possibly due to a greater decrease in compartment loading during knee flexion.Level of evidence:level IV, therapeutic case series.

Keywords

posterior tibial slope - joint awareness - patient satisfaction - total knee arthroplasty - compartment loading

Ethical Approval

This institutional review board of the author's institution approved this retrospective study (approval number: TGE01668–066).


Ethics Approval

This is a controlled laboratory study that did not involve human subjects. Ethical approval is not required.


Authors' Contribution

H.O. was responsible for study design, data analysis, and statistical analysis. Data collection wasperformed by H.O., Y.N., M.S., T.S., and K.O. The initial draft of the manuscript was written by H.O., Y.N., M.S., T.S., K.O., and H.A. All authors read and approved the final version of the manuscript.




Publication History

Received: 28 September 2022

Accepted: 12 May 2023

Accepted Manuscript online:
16 May 2023

Article published online:
03 July 2023

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