Effect of Tibial Posterior Slope on Knee Kinematics, Quadriceps Force, and Patellofemoral Contact Force After Posterior-Stabilized Total Knee Arthroplasty

Okamoto, Shogo; Mizu-uchi, Hideki; Okazaki, Ken; Hamai, Satoshi; Nakahara, Hiroyuki; Iwamoto, Yukihide

doi:10.1016/j.arth.2015.02.042

Cited by 56 publications

(71 citation statements)

References 32 publications

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“…The increased PTS can be expected to reduce the quadriceps force and the patellar button contact stress required for deep knee bending to some extent. In addition, decreased quadriceps force and patellar button contact stress showed similar trend with previous study as PTS increased during flexion [ 20 ]. However, the contact stress on post in PE insert increased as PTS increased.…”

Section: Discussionsupporting

confidence: 87%

“…However, the contact stress on post in PE insert increased as PTS increased. Anterior impingement between the tibial post and the femoral component was observed at near-full extension with 10° or more of PTS [ 20 ]. In other words, excessive PTS can lead to anterior impingement between the tibial post and the femoral component because of the post-cam mechanism, and excessive PTS also leads to increased contact stress on post in PE insert.…”

Section: Discussionmentioning

confidence: 99%

“…First, there was a virtual and variable model used in this simulation, and the material properties of soft tissues were obtained from relevant cadaveric studies. These are common methods in computational studies [ 20 – 26 , 29 , 31 , 33 , 35 , 36 , 41 ]. Second, the results could not substitute clinical results and consider patient satisfaction because they were the outcomes of FE analyses.…”

Section: Discussionmentioning

confidence: 99%

“…Shi et al reported that an increase in the PTS can significantly increase the postoperative maximal knee flexion in PS TKA [ 19 ]. Okamoto et al reported that the maximum quadriceps force and patellofemoral (PF) contact force decreased with increasing PTS [ 20 ]. They supported the suggestion that increased PTS contributes to improved exercise efficiency during knee extension; however, excessive PTS should be avoided to prevent knee instability [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Okamoto et al reported that the maximum quadriceps force and patellofemoral (PF) contact force decreased with increasing PTS [ 20 ]. They supported the suggestion that increased PTS contributes to improved exercise efficiency during knee extension; however, excessive PTS should be avoided to prevent knee instability [ 20 ]. PCO and PTS lead to diverse biomechanical effects, as mentioned above, and there still exists no consensus as the results depend on the CR and PS types of TKA.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical Effects of Posterior Condylar Offset and Posterior Tibial Slope on Quadriceps Force and Joint Contact Forces in Posterior-Stabilized Total Knee Arthroplasty

Kang

Koh

Son

et al. 2017

BioMed Research International

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This study aimed to determine the biomechanical effect of the posterior condylar offset (PCO) and posterior tibial slope (PTS) in posterior-stabilized (PS) fixed-bearing total knee arthroplasty (TKA). We developed ±1, ±2, and ±3 mm PCO models in the posterior direction and −3°, 0°, 3°, and 6° PTS models using a previously validated FE model. The influence of changes in the PCO and PTS on the biomechanical effects under deep-knee-bend loading was investigated. The contact stress on the PE insert increased by 14% and decreased by 7% on average as the PCO increased and decreased, respectively, compared to the neutral position. In addition, the contact stress on post in PE insert increased by 18% on average as PTS increased from −3° to 6°. However, the contact stress on the patellar button decreased by 11% on average as PTS increased from −3° to 6° in all different PCO cases. The quadriceps force decreased by 14% as PTS increased from −3° to 6° in all PCO models. The same trend was found in patellar tendon force. Changes in PCO had adverse biomechanical effects whereas PTS increase had positive biomechanical effects. However, excessive PTS should be avoided to prevent knee instability and subsequent failure.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%