Comparisons of kinematics and range of motion in high-flexion total knee arthroplasty: cruciate retaining vs. substituting designs

INTRODUCTION Debate has persisted for many years about whether to sacrifice or replace the posterior cruciate ligament when performing total knee arthroplasty. A paucity of long-term follow-up studies comparing outcomes between cruciate-retaining and posterior-stabilised knees exist. We aimed to compare results at ten-year follow-up. METHODS A matched paired study comparing a cohort of 107 Zimmer Nexgen® Cruciate Retaining (CR) patients with a cohort of 107 Nexgen Posterior-Stabilised (PS) knees matched for age, sex, body mass index and preoperative American Knee Society score was undertaken. All patients underwent independent clinical assessment and knee society scoring preoperatively and at 1, 3, 5, 7 and 10 years postoperatively. RESULTS Fifty-three patients (49.5%) in the CR group and 44 patients (41.1%) in the PS group were alive at 10-year follow-up. There were no significant differences between the CR and PS groups with regards to functional assessment (P = 0.95), overall range of movement (P = 0.46) or patient satisfaction (P = 1.0) at 10 years. However, there was a significantly better score improvement in range of movement in PS knees compared with CR knees (P = 0.027). There were six revisions (5.6%) in the PS group and 1 (0.93%) in the CR group (P = 0.12). Both CR and PS knees showed excellent survivorship with no significant difference at 10 years (P = 0.068). CONCLUSIONS There were no significant differences in functional score, overall range of motion or patient satisfaction between the Nexgen cruciate retaining and posterior stabilised total knee arthroplasty at 10-year follow-up. However, PS knees had a greater score improvement in range of motion compared with CR knees.

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Similar stability and range of motion between cruciate-retaining and cruciate-substituting ultracongruent insert total knee arthroplasty

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-014-2892-x ◽

2014 ◽

Vol 23 (6) ◽

pp. 1638-1643 ◽

Cited By ~ 24

Author(s):

Jörg Lützner ◽

F.-P. Firmbach ◽

C. Lützner ◽

J. Dexel ◽

S. Kirschner

Keyword(s):

Total Knee Arthroplasty ◽

Range Of Motion ◽

Knee Arthroplasty ◽

Cruciate Retaining ◽

Ultracongruent Insert ◽

Total Knee

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No difference between standard and high flexion cruciate retaining total knee arthroplasty: a prospective randomised controlled study

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-014-3082-6 ◽

2014 ◽

Vol 23 (6) ◽

pp. 1591-1597 ◽

Cited By ~ 4

Author(s):

Hans Robert Springorum ◽

Günther Maderbacher ◽

Benjamin Craiovan ◽

Christian Lüring ◽

Clemens Baier ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Controlled Study ◽

Cruciate Retaining ◽

High Flexion ◽

Randomised Controlled Study ◽

Total Knee ◽

Randomised Controlled

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A Surgical Reduction Technique for Posterior Cruciate Ligament Avulsion Fracture in Total Knee Arthroplasty: A Comparison Study

10.21203/rs.2.22829/v4 ◽

2020 ◽

Author(s):

Wei Lin ◽

Jinghui Niu ◽

Yike Dai ◽

Huaxing Zhang ◽

Jing Zhu ◽

...

Keyword(s):

Risk Factors ◽

Total Knee Arthroplasty ◽

Range Of Motion ◽

Posterior Cruciate Ligament ◽

Knee Arthroplasty ◽

Avulsion Fracture ◽

Cruciate Ligament ◽

Cruciate Retaining ◽

Total Knee ◽

Pcl Avulsion

Abstract Background: Posterior cruciate ligament (PCL) avulsion fracture of tibia is an uncommon but serious complication during primary cruciate retaining total knee arthroplasty (TKA). The first objective of this report was to conduct a retrospective cohort study to investigate the incidence and potential risk factors of PCL avulsion fracture in primary cruciate-retaining TKA. The second objective was to assess the functional outcomes of the knee after reduction of PCL avulsion fracture.Methods: From January 2014 to January 2016, 56 patients who experienced PCL avulsion fracture of tibia in primary cruciate-retaining TKA were included in study group. Patients in this group underwent reduction of avulsion fracture. In this period, we selected 224 patients (control group) for comparison. Patients in this group also underwent the same TKA but no PCL avulsion fracture occurred. Range of motion of the knee and Knee Society Scores were assessed. The forgotten joint score was used to analyze the ability to forget the joint. Differences were considered statistically significant at p < 0.05.Results: In our series, the incidence of PCL avulsion fracture was 4.6%. There was no significant differences (p > 0.05) with regard to preoperative or postoperative range of motion of the knee, final 4 year mean clinical score in study and control groups 92.4 ± 2.7 and 93.6 ± 1.9, respectively, and mean functional scores of 85.1 ± 1.8 and 87.1 ± 1.2, respectively.Conclusions: The incidence of PCL avulsion fracture of tibia is relatively high. Older age and female gender were two risk factors of fracture in primary cruciate-retaining TKA. Reduction of PCL avulsion fracture with high-strength line can achieve good stability and function of the knee.

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