The association between restoration of tibial slope and total knee arthroplasty outcomes

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-06-16 DOI:10.1016/j.jor.2025.06.012

Asher Selznick , Hassaan Abdel Khalik , Prushoth Vivekanantha , Bryan Sun , Kamal Bali

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引用次数: 0

Abstract

Background

The proximal tibia has a characteristic posterior slope, varying between individuals and implicated in biomechanical function. This study evaluated whether restoring the native posterior tibial slope during primary total knee arthroplasty (TKA) improves postoperative functional outcomes.

Methods

A retrospective review of 9569 TKA patients from 1998 to 2022 was conducted using a single-centre arthroplasty database. Patients were categorized based on changes in tibial slope: decreased (Group 1, Δ slope <3°), re-created (Group 2, Δ slope −3 to +3°), or increased (Group 3, Δ slope >3°). Preoperative and postoperative anterior and posterior femoral offset ratios were also calculated and analyzed as covariates. Postoperative functional outcomes and range of motion (ROM) were assessed using analyses of covariance (ANCOVAS) and post-hoc pairwise comparisons.

Results

Among 609 included patients, tibial slope was decreased in 278 patients (46%, Group 1), re-created in 253 (42%, Group 2), and increased in 78 (13%, Group 3). Group 2 exhibited a 4.8-point higher Knee Society Score at six weeks postoperatively compared to Group 1 (p = 0.004), though scores at other time points and Oxford Knee Scores across all time points showed no significant differences between groups (p > 0.05). Maximal flexion did not differ significantly across groups. These findings were consistent after adjusting for femoral offset ratio changes.

Conclusion

Recreation of native tibial slope was associated with a statistically significant but clinically minor improvement in postoperative functional outcome scores. Increasing tibial slope was not associated with improvements in maximal flexion, although this may be confounded by variations in implants utilized.

Loe

III (Retrospective cohort study).

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胫骨斜度恢复与全膝关节置换术结果的关系

背景胫骨近端有一个特征性的后斜面，因人而异，与生物力学功能有关。本研究评估初次全膝关节置换术（TKA）中恢复胫骨后斜坡是否能改善术后功能预后。方法回顾性分析1998年至2022年9569例TKA患者的单中心关节置换术数据库。患者根据胫骨斜率的变化进行分类：减少（1组，Δ斜率<；3°），重建（2组，Δ斜率- 3至+3°）或增加（3组，Δ斜率>；3°）。术前和术后股骨前后偏置比也作为协变量计算和分析。使用协方差分析（ANCOVAS）和事后两两比较评估术后功能结局和活动范围（ROM）。结果609例患者中，胫骨斜度下降278例（46%，组1），重建253例（42%，组2），增加78例（13%，组3）。2组术后6周膝关节社会评分比1组高4.8分（p = 0.004），但其他时间点的评分和所有时间点的牛津膝关节评分在组间无显著差异(p >；0.05)。最大屈曲在各组间无显著差异。在调整股骨偏移比变化后，这些结果是一致的。结论原位胫骨斜坡的重建与术后功能结局评分的改善有统计学意义，但临床上改善较小。增加胫骨斜率与最大屈曲的改善无关，尽管这可能与所使用的植入物的变化相混淆。LoeIII（回顾性队列研究）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.