Cruciate retaining versus posterior-stabilized total knee arthroplasty: a short-term comparative study

Authors

  • Raghav K. Suthar Department of Orthopedics, Parekhs Hospital, Ahmedabad, Gujarat, India
  • Dimple R. Parekh Head of Orthopedics and Joint Replacement Surgery, Parekhs Hospital, Ahmedabad, Gujarat, India
  • Shaival B. Mistry Department of Orthopedics, Ahmedabad Physiotherapy College, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20183671

Keywords:

Total knee arthroplasty, Cruciate retaining knees, Posterior-stabilized knees, Osteoarthritis of knee

Abstract

Background: Total knee arthroplasty has got excellent results. Among the techniques (posterior-stabilized vs posterior cruciate retaining total knee arthroplasty) it is unclear whether one design has superior outcome over another. The purpose of the present study was to directly compare clinical and radiological outcomes of these two designs.

Methods: A prospective study involving 36 patients who received a cruciate-retaining implant were compared to 30 patients who received posterior-stabilized prosthesis. At 3 months follow-up time clinical and radiological evaluation done and results were analyzed.

Results: At 3 months follow-up time mean knee society scores improved from 49.9/46.9 (objective/subjective score) points to 80.9/82.5 points in the cruciate-retaining group and from 48.2/43 (objective/subjective score) points to 80.4/80.2 points in the posterior-stabilized group. The ranges of motion was 117.2° (range, 90° to 130°) and 125.3° (range, 100° to 140°) in the cruciate-retaining and posterior-stabilized group respectively, at 3 month follow-up. One patient had post-operatively periprosthetic fracture reported after 2 weeks (treated conservatively), one had superficial infection (treated with dressing) and one patient with superfical infection required debridement.

Conclusions: This study did not conclusively demonstrate the superiority of one knee design over the other, suggesting that the choice of implant should be based on surgeon preference, patients knee dimensions, pre-op knee deformity and existing pathology of the posterior cruciate ligament.

References

Attar FG, Khaw FM, Kirk LM, Gregg PJ. Survivorship analysis at 15 years of cemented press-fit condylar total knee arthroplasty. J Arthroplasty. 2008;23:344-9.

Baker PN, Khaw FM, Kirk LM, Esler CN, Gregg PJ. A randomised controlled trial of cemented versus cementless press-fit condylar total knee replacement:15-year survival analysis. J Bone Joint Surg Br. 2007;89:1608-14.

Khaw FM, Kirk LM, Morris RW, Gregg PJ. A randomised, controlled trial of cemented versus cementless press-fit condylar total knee replacement. Ten-year survival analysis. J Bone Joint Surg Br. 2002;84:658-66.

Langlais F, Belot N, Ropars M, Lambotte JC, Thomazeau H. The long-term results of press-fit cemented stems in total knee prostheses. J Bone Joint Surg Br. 2006;88:1022-6.

Rodricks DJ, Patil S, Pulido P, Colwell CW, Jr.Press-fit condylar design total knee arthroplasty. Fourteen to seventeen-year follow-up. J Bone Joint Surg Am. 2007;89:89-95.

Vessely MB, Whaley AL, Harmsen WS, Schleck CD, Berr y DJ. The chitranjan ranawat award:Long-term survivorship and failure modes of 1000 cemented condylar total knee arthroplasties. Clin Orthop Relat Res. 2006;452:28-34.

Yoshiya S, Matsui N, Komistek RD, Dennis DA, Mahfouz M, Kurosaka M. In vivo kinematic comparison of posterior cruciate-retaining and posterior stabilized total knee arthroplasties under passive and weight-bearing conditions. J Arthroplasty. 2005;20:777-83.

Fantozzi S, Catani F, Ensini A, Leardini A, Giannini S. Femoral rollback of cruciate-retaining and posterior-stabilized total knee replacements:In vivo fluoroscopic analysis during activities of daily living. J Orthop Res. 2006;24:2222-9.

Nabeyama R, Matsuda S, Miura H, Kawano T, Nagamine R, Mawatari T, Tanaka K, Iwamoto Y. Changes in anteroposterior stability following total knee arthroplasty. J Orthop Sci. 2003;8:526-31.

Maruyama S, Yoshiya S, Matsui N, Kuroda R, Kurosaka M. Functional comparison of posterior cruciate-retaining versus posterior stabilized total knee arthroplasty. J Arthroplasty. 2004;19:349-53.

Arabori M, Matsui N, Kuroda R, Mizuno K, Doita M, Kurosaka M, et al. Posterior condylar offset and flexion in posterior cruciate-retaining and posterior stabilized tka. J Orthop Sci. 2008;13:46-50.

Scott WN, Insall JN. A third-generation, posteriorstabilized knee prosthesis:Early results after followup of 2 to 6 years. J Arthroplasty. 2006;21:821-5.

Kolisek FR, Barnes CL. Scorpio posterior-stabilized knee system:5-year clinical and functional results. J Arthroplasty. 2006;21:1187-92.

Lachiewicz PF, Soileau ES. The rates of osteolysis and loosening associated with a modular posterior stabilized knee replacement. Results at five to fourteen years. J Bone Joint Surg Am. 2004;86:525-30.

Dalury DF, Gonzales RA, Adams MJ, Gruen TA, Trier K. Midterm results with the pfc sigma total knee arthroplasty system. J Arthroplasty. 2008;23:175-81.

Kubiak P, Archibeck MJ, White RE, Jr. Cruciateretaining total knee arthroplasty in patients with at least fifteen degrees of coronal plane deformity. J Arthroplasty. 2008;23:366-70.

Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the knee society clinical rating system. Clin Orthop Relat Res. 1989;13-4.

Ewald FC. The knee society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res. 1989;248:9-12.

Vail TP, Lang JE. Insall and Scott surgery of the knee. 4th ed. Philadelphia:Churchill Livingstone, Elsevier; 2006:1455-1521.

Insall J, Ranawat CS, Scott WN, Walker P. Total condylar knee replacement. Preliminary report. Clin Orthop Relat Res. 1976;120:149-54.

Vilchez F, Martinez-Pastor JC, Garcia-Ramiro S, Bori G, Tornero E, Garcia E, et al. Efficacy of debridement in hematogenous and early post-surgical prosthetic joint infections. Int. J. Artif. Organs. 2011;34:863–9.

Ehlinger M, Adam P, Abane L, Rahme M, Moor BK, Arlettaz Y, Bonnomet F. Treatment of periprosthetic femoral fractures of the knee. Knee Surg Sports Traumatol Arthrosc. 2011;19:1473–1478.

Maruyama S, Yoshiya S, Matsui N, Kuroda R, Kurosaka M. Functional comparison of posterior cruciate-retaining versus posterior stabilized total knee arthroplasty. J Arthroplasty. 2004;19:349-53.

Yoshiya S, Matsui N, Komistek RD, Dennis DA, Mahfouz M, Kurosaka M. In vivo kinematic comparison of posterior cruciate-retaining and posterior stabilized total knee arthroplasties under passive and weight-bearing conditions. J Arthroplasty. 2005;20:777-83.

Bolanos AA, Colizza WA, McCann PD, Gotlin RS, Wootten ME, Kahn BA, et al. A comparison of isokinetic strength testing and gait analysis in patients with posterior cruciate-retaining and substituting knee arthroplasties. J Arthroplasty. 1998;13:906-15.

Tanzer M, Smith K, Burnett S. Posterior-stabilized versus cruciate-retaining total knee arthroplasty: Balancing the gap. J Arthroplasty. 2002;17:813-9.

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Published

2018-08-25

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Original Research Articles