Optimization of the Posterior Condylar Offset, Tibial Slope, and Condylar Roll-back in Total Knee Arthroplasty

Total knee arthroplasty does not restore the full range of motion of the knee. Retrospective clinical studies on knee kinematics suffer from multiple biases because the various parameters involved, that is, the posterior condylar offset, the tibial slope, and the condylar roll-back, are not individu...

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Bibliographic Details
Published in:The Journal of arthroplasty 2006-09, Vol.21 (6), p.889-896
Main Authors: Massin, Philippe, Gournay, Antoine
Format: Article
Language:English
Subjects:
Arthroplasty, Replacement, Knee - methods
Biomechanical Phenomena
Femur - physiology
Femur - surgery
Humans
knee flexion
Knee Joint - diagnostic imaging
Knee Joint - physiology
knee kinematics
Osteotomy
posterior condylar offset
Radiography
Range of Motion, Articular
Reproducibility of Results
Tibia - physiology
Tibia - surgery
tibial slope
total knee arthroplasty
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Summary:Total knee arthroplasty does not restore the full range of motion of the knee. Retrospective clinical studies on knee kinematics suffer from multiple biases because the various parameters involved, that is, the posterior condylar offset, the tibial slope, and the condylar roll-back, are not individualized. The present study, based on the geometry of knee flexion, shows that a 3-mm decrease of the posterior condylar offset could reduce knee flexion by 10° before the occurrence of tibiofemoral impingement. In addition, the simultaneous decrease of the tibial slope by 5° could reduce the flexion by a further 5°. These effects could be reinforced if the paradoxical condylar roll-forward was made to exceed 10 mm. Finally, decreasing the condylar offset in a prosthesis with a paradoxical roll-forward and a neutral tibial slope could reduce maximum obtainable knee flexion before impingement by as much as 30°.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2005.10.019