| Objective:To explore the effect of Posteau Slope Angle(PSA)on Knee flexion function after Total Knee Arthroplasty(TKA).Methods:A retrospective study was conducted on 72 patients who underwent TKA by the same surgical team in the First Affiliated Hospital of Dali University from September 2020 to February 2022,including 60 female patients and 12 male patients.All patients received posterior cruciate ligament replacement total knee prosthesis(Weigao Sea Star GKPS total knee prosthesis).Lateral radiographs of the knee joint were taken before and after surgery,and the values of the posterior dip Angle of the tibial plateau before and after surgery were measured and recorded on the lateral radiographs of the knee joint.According to the preoperative and postoperative PSA values of the patients,72 patients were divided into 3 groups:Group A was set as the group with PSA reduction compared with the group before surgery;group B was set as the group with PSA increase ≤3° compared with the group before surgery;group C was set as the group with PSA increase > 3° compared with the group before surgery.The maximum knee flexion Angle and HSS score were measured before surgery,the first day after surgery,1 month,3 months,6 months and 1 year after surgery.Results: 1.Preoperative PSA: 10.22±1.86° in group A,6.82±2.55° in group B and 6.34 ±2.39° in group C.The difference between group A,group B and group C was statistically significant(P<0.001).There was no statistical significance between group C and group B(P>0.05).Postoperative PSA status: Group A was 2.97±2.80°,group B was 8.60±2.45°,and group C was 11.61±2.54°.There was no statistical significance between group A and group B(P> 0.05).The difference between group A and group C was statistically significant(P<0.001).The difference between group C and group B was statistically significant(P<0.001).2.The maximum active knee flexion Angle in the three groups before surgery was 103.78±4.44° in group A,103.28±4.38° in group B and 103.52±4.12° in group C.The pairwise comparison among groups A,B and C showed no statistical significance(P> 0.05).On the first day after surgery,the maximum active flexion Angle of knee joint was 89.5±5.57° in group A,89.27±5.01° in group B and 92.80±4.86° in group C.There was no statistical significance between group A and group B(P>0.05).The difference between group C and group A and B was statistically significant(P<0.001).The maximum active knee flexion Angle 1 month after surgery was 105.28±4.93° in group A,112.29±6.02° in group B and 114±6.25° in group C.The difference between group A and group B and C was statistically significant(P< 0.001).There was no statistical significance between group C and group B(P > 0.05).The maximum active knee flexion Angle 3 months after surgery was 115.61±4.24° in group A,122.28±3.66° in group B and 125.48±3.98° in group C.The difference between group A and group B and C was statistically significant(P<0.001).There was no statistical significance between group C and group B(P>0.05).The maximum active knee flexion Angle 6 months after surgery was 119.17±2.38° in group A,124.34±3.56° in group B and 126.24±3.63° in group C.The pairwise comparison among group A,group B and group C showed statistically significant difference(P<0.001).One year after surgery,the maximum active flexion Angle of knee joint was 119.44±1.82° in group A,125.00±2.87° in group B and 127.12±3.19° in group C.The pairwise comparison among group A,group B and group C showed statistically significant difference(P<0.001).3.Intra-group comparison:(1)PSA reduction group compared with preoperative group: maximum knee flexion Angle before surgery and during follow-up: 103.78±4.44° before surgery,89.5±5.57° on the first day after surgery,105.28±4.93° 1 month after surgery,115.61±4.24° 3 months after surgery,and 6 months after surgery:It was 119.17±2.38° and 119.44±1.82° one year after surgery.The difference was not statistically significant before surgery and one month after surgery(P>0.05).The difference was statistically significant before surgery and one day after surgery,three months after surgery,six months after surgery and one year after surgery(P < 0.001).(2)Group with PSA ≤3° greater than that before surgery: maximum knee flexion Angle before surgery and during follow-up:103.28±4.38° before surgery,89.27±5.01° on the first day after surgery,112.29±6.02° one month after surgery,122.28±3.66° three months after surgery,124.34±3.56° six months after surgery,125.00 ±2.87° one year after surgery.The difference between preoperative and postoperative day 1,postoperative 1 month,postoperative 3 months,postoperative 6 months and postoperative 1 year was statistically significant(P<0.001).(3)PSA > 3° higher than that before surgery: maximum knee flexion Angle before surgery and during follow-up:103.52±4.12° before surgery,92.80±4.86° on the first day after surgery,114±6.25° one month after surgery,125.48±3.98° three months after surgery,26.24±3.63° six months after surgery,127.12±3.19° one year after surgery.The difference between preoperative and postoperative day 1,postoperative 1 month,postoperative 3 months,postoperative 6 months and postoperative 1 year was statistically significant(P<0.001).4.The correlation between postoperative PSA and maximum knee flexion Angle: postoperative PSA was 9.28±2.88°,and the maximum knee flexion Angle one year after TKA was 124.34±4.06.spearma correlation analysis was used to analyze the correlation between PSA and maximum knee flexion Angle after surgery,and the statistical results showed that PSA was correlated with maximum knee flexion Angle(r=0.314,P<0.05).5.Preoperative and postoperative HSS scores: Preoperative and postoperative HSS scores of the three groups were compared by One-way ANOVA Test..Preoperative HSS score: Group A,group B,group C,52.72±3.77,52.33±4.73,52.24±4.52;There was no significant difference between group A and group B(P>0.05).There was no significant difference between group A and group C(P>0.05).There was no significant difference between group C and group B(P > 0.05).Postoperative HSS score: Group A HSS score: 90.89±2.34,group B HSS score: 90.17±2.47,group C HSS score: 90.82±1.90;There was no significant difference between group A and group B(P>0.05).There was no statistical significance between group A and group C(P>0.05).There was no significant difference between group C and group B(P>0.05).6.The correlation between postoperative PSA and HSS score was as follows: postoperative PSA was 9.28±2.88°,postoperative HSS score was 90.43±2.24;spearma correlation analysis was used to analyze the correlation between PSA and HSS score after surgery,and the statistical results showed no correlation between PSA and HSS score(r=0.007,P>0.05).Conclusion:1.The posteau slope angle is correlated with the knee flexion function.The reduction of the posteau slope angle after TKA is not conducive to the recovery of knee flexion function,and the increase of the posteau slope angle by 3° ~ 6° after TKA can promote the recovery of knee flexion function.2.Posteau slope angle has no significant effect on postoperative HSS score. |
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