Effect of Posterior Tibial Slope on Flexion and Anterior-Posterior Tibial Translation in Posterior Cruciate-Retaining Total Knee Arthroplasty

J Arthroplasty. 2016 Jan;31(1):103-6. doi: 10.1016/j.arth.2015.08.027. Epub 2015 Aug 29.


Reduced posterior tibial slope (PTS) and posterior tibiofemoral translation (PTFT) in posterior cruciate-retaining (PCR) total knee arthroplasty (TKA) may result in suboptimal flexion. We evaluated the relationship between PTS, PTFT, and total knee flexion after PCR TKA in a cadaveric model. We performed a balanced PCR TKA using 9 transfemoral cadaver specimens and changed postoperative PTS in 1° increments. We measured maximal flexion and relative PTFT at maximal flexion. We determined significant changes in flexion and PTFT as a function of PTS. Findings showed an average increase in flexion of 2.3° and average PTFT increase of 1mm per degree of PTS increase when increasing PTS from 1° to 4° (P<.05). Small initial increases in PTS appear to significantly increase knee flexion and PTFT.

Keywords: maximum flexion; posterior tibial slope; posterior tibial translation; primary knee arthroplasty; tibiofemoral translation; total knee replacement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee / methods*
  • Biomechanical Phenomena
  • Cadaver
  • Female
  • Humans
  • Knee Joint / surgery*
  • Male
  • Movement
  • Muscle, Skeletal / physiology
  • Orthopedics / methods
  • Posterior Cruciate Ligament / surgery
  • Postoperative Period
  • Range of Motion, Articular
  • Tibia / anatomy & histology*
  • Tibia / surgery*