How to Choose the Appropriate Posterior Slope Angle Can Lead to Good Knee Joint Function Recovery in Total Knee Arthroplasty?

In this study, we aimed to examine the effects of osteotomy under varying posterior tibial slope (PTS) angles on knee joint function recovery following total knee arthroplasty (TKA). Methods: A retrospective analysis was conducted on 240 patients who underwent cruciate-retaining TKA and were evaluated 3 years after surgery. Patients were grouped by change in PTS from pre- to postoperative: Group 1, >5°; Group 2, 3°–5°; Group 3, 0°–3°; Group 4, −3°–0°; Group 5, <−3°. Outcomes included Knee Society Score (KSS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Visual Analogue Scale (VAS) pain, and postoperative complications. Results: Pain decreased significantly versus preoperative levels (VAS 1.0–3.0 across groups; H=93.400, P<0.001). KSS increased with significant between-group differences (H=164.460, P<0.001); Group 2 had the highest median KSS (97.0) and Group 5 the lowest (78.0). WOMAC scores were reduced with medians of 24.0, 11.0, 14.0, 20.0, and 26.0 for Groups 1–5, respectively (H=164.223, P<0.001). No periprosthetic femoral fracture, prosthetic loosening, or polyethylene wear was detected. Conclusion: Variation in PTS after TKA affects postoperative functional rehabilitation; excessive increases or decreases in PTS adversely impact recovery, while a modest reduction appears most favorable.