The Role of Posterior Tibial Slope in Range of Motion After Total Knee Arthroplasty for Haemophilia Patients: A Retrospective Study.

INTRODUCTION

Patients with haemophilia typically achieve only approximately a 90° range of motion (ROM) following total knee arthroplasty (TKA), which still significantly affects their daily life.

AIM: Studies have indicated that the posterior tibial slope (PTS) and posterior condylar offset (PCO) are associated with ROM following TKA. However, it remains unclear whether these findings are applicable to patients with haemophilia, given their distinct skeletal anatomy compared to the general population.

METHODS

A retrospective review was conducted on 56 patients (71 knees) who underwent TKA at our centre from January 2018 to December 2022. Demographic information, viral infections, postoperative PTS, PCO, posterior condylar offset ratio (PCOR) and ROM at 1-year post-surgery were documented for each patient. We investigated the impact of PTS, PCO and PCOR on postoperative ROM using t-tests and regression analysis.

RESULTS

One year after TKA, patients with haemophilia demonstrated ROM of 89.61°. Larger PTS group exhibited a greater ROM compared to smaller PTS group. This phenomenon was also observed with PCOR. Multiple regression analysis uncovered a positive correlation between postoperative PTS (B = 0.933, p < 0.001) and PCOR (B = 22.417, p = 0.047) and postoperative ROM. Furthermore, postoperative pain showed a negative correlation with ROM (B = -5.377, p < 0.001), whereas preoperative ROM exhibited a positive correlation with it (B = 0.285, p < 0.001).

CONCLUSION

Properly increasing PTS and PCOR during surgery may lead to increased postoperative ROM for patients with haemophilia. Furthermore, effective postoperative pain management also aids patients in their recovery of ROM.