Importance of posterior tibial slope in joint kinematics with an anterior cruciate ligament-deficient knee

Bone & Joint Research

article

Liming Shu¹  Nobuhiro Abe²  Shihao Li¹  Naohiko Sugita¹ 

[1] Research into Artifacts, Center for Engineering, School of Engineering, The University of Tokyo;Department of Orthopaedic Surgery and Sport Medicine, General Medical Center, Kawasaki Medical School

关键词: Anterior cruciate ligament deficiency;    Osteoarthritis knee;    Posterior tibial slope;    Meniscus tear;    Joint kinematics;    posterior tibial slope;    Knee(s);    anterior cruciate ligament (ACL);    meniscus;    medial meniscus;    tibiofemoral and patellofemoral joints;    kinematics;    anterior cruciate ligament-deficient knee;    meniscus tear;   

DOI  :  10.1302/2046-3758.1110.BJR-2022-0039.R1

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsTo fully quantify the effect of posterior tibial slope (PTS) angles on joint kinematics and contact mechanics of intact and anterior cruciate ligament-deficient (ACLD) knees during the gait cycle.MethodsIn this controlled laboratory study, we developed an original multiscale subject-specific finite element musculoskeletal framework model and integrated it with the tibiofemoral and patellofemoral joints with high-fidelity joint motion representations, to investigate the effects of 2.5° increases in PTS angles on joint dynamics and contact mechanics during the gait cycle.ResultsThe ACL tensile force in the intact knee was significantly affected with increasing PTS angle. Considerable differences were observed in kinematics and initial posterior femoral translation between the intact and ACLD joints as the PTS angles increased by more than 2.5° (beyond 11.4°). Additionally, a higher contact stress was detected in the peripheral posterior horn areas of the menisci with increasing PTS angle during the gait cycle. The maximum tensile force on the horn of the medial meniscus increased from 73.9 N to 172.4 N in the ACLD joint with increasing PTS angles.ConclusionKnee joint instability and larger loading on the medial meniscus were found on the ACLD knee even at a 2.5° increase in PTS angle (larger than 11.4°). Our biomechanical findings support recent clinical evidence of a high risk of failure of ACL reconstruction with steeper PTS and the necessity of ACL reconstruction, which would prevent meniscus tear and thus the development or progression of osteoarthritis.

【 授权许可】

CC BY-NC