ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2013
Significant effect of the posterior tibial slope and medial/lateral ligament balance on knee flexion in total knee arthroplasty.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Mean distraction force applied in tension-controlled ligament-balanced total knee arthroplasty: A systematic review and meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Pooled it
- Sexual dimorphism of the posterior condylar offset of the femur and the medial posterior slope of the tibia in non-arthritic knees of Egyptian adults: an MRI study.Journal of orthopaedic surgery and research · 2023Trial
- Reduction Osteotomy versus Extensive Release on Clinical Outcome Measures in Simultaneous Bilateral Total Knee Arthroplasty.Medical science monitor : international medical journal of experimental and clinical research · 2017Trial
- Changes in femoral posterior condylar offset and knee flexion after PCL-substituting total knee arthroplasty: comparison of anterior and posterior referencing systems.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2016Trial
- Surgically modifiable factors measured by computer-navigation together with patient-specific factors predict knee society score after total knee arthroplasty.BMC musculoskeletal disorders · 2016Trial
- The influence of the tibial slope on intra-operative soft tissue balance in cruciate-retaining and posterior-stabilized total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2014Trial
- The Role of Posterior Tibial Slope in Range of Motion After Total Knee Arthroplasty for Haemophilia Patients: A Retrospective Study.Haemophilia : the official journal of the World Federation of Hemophilia · 2025Article
- The impact of femoral flexion angle and tibial slope on knee gap in total knee arthroplasty.Arthroplasty (London, England) · 2025Article
- Article
- Posterior tibial slope considered as an important addition to the CPAK classification system.Journal of orthopaedics · 2024Article
- Posterior tibial slope influences joint mechanics and soft tissue loading after total knee arthroplasty.Frontiers in bioengineering and biotechnology · 2024Article
- Does mild flexion of the femoral prosthesis in total knee arthroplasty result in better early postoperative outcomes?BMC musculoskeletal disorders · 2023Article
- Effect of anterior tibial bowing on measurement of posterior tibial slope on conventional X-rays.Archives of orthopaedic and trauma surgery · 2023Article
- No influence of posterior tibial slope change on outcomes after cruciate-retaining total knee arthroplasty: a prospective cohort study.Archives of orthopaedic and trauma surgery · 2023Article
- Is combined robotically assisted unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction a good solution for the young arthritic knee?International orthopaedics · 2023Article
- Posteromedial Corner Release with the Knee in Figure-of-Four Position vs Conventional Position for Varus Knee Arthroplasty.Orthopaedic surgery · 2021Article
- Mid-flexion stability in the anteroposterior plane is achieved with a medial congruent insert in cruciate-retaining total knee arthroplasty for varus osteoarthritis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Article
- Tibiofemoral rotational alignment affects flexion angles in navigated posterior-stabilized total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018Article
- A computational simulation study to determine the biomechanical influence of posterior condylar offset and tibial slope in cruciate retaining total knee arthroplasty.Bone & joint research · 2018Article
- Patient-specific and intra-operatively modifiable factors assessed by computer navigation predict maximal knee flexion one year after TKA.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2016Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe intra-operative femorotibial joint gap and ligament balance, the predictors affecting these gaps and their balances, as well as the postoperative knee flexion, were examined. These factors were assessed radiographically after a posterior cruciate-retaining total knee arthroplasty (TKA). The posterior condylar offset and posterior tibial slope have been reported as the most important intra-operative factors affecting cruciate-retaining-type TKAs. The joint gap and balance have not been investigated in assessments of the posterior condylar offset and the posterior tibial slope.
methodsThe femorotibial gap and medial/lateral ligament balance were measured with an offset-type tensor. The femorotibial gaps were measured at 0°, 45°, 90° and 135° of knee flexion, and various gap changes were calculated at 0°-90° and 0°-135°. Cruciate-retaining-type arthroplasties were performed in 98 knees with varus osteoarthritis.
resultsThe 0°-90° femorotibial gap change was strongly affected by the posterior condylar offset value (postoperative posterior condylar offset subtracted by the preoperative posterior condylar offset). The 0°-135° femorotibial gap change was significantly correlated with the posterior tibial slope and the 135° medial/lateral ligament balance. The postoperative flexion angle was positively correlated with the preoperative flexion angle, γ angle and the posterior tibial slope. Multiple-regression analysis demonstrated that the preoperative flexion angle, γ angle, posterior tibial slope and 90° medial/lateral ligament balance were significant independent factors for the postoperative knee flexion angle. The flexion angle change (postoperative flexion angle subtracted by the preoperative flexion angle) was also strongly correlated with the preoperative flexion angle, posterior tibial slope and 90° medial/lateral ligament balance.
conclusionThe postoperative flexion angle is affected by multiple factors, especially in cruciate-retaining-type TKAs. However, it is important to pay attention not only to the posterior tibial slope, but also to the flexion medial/lateral ligament balance during surgery. A cruciate-retaining-type TKA has the potential to achieve both stability and a wide range of motion and to improve the patients' activities of daily living.
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