The Influence of the Posterior Cruciate Ligament and Component Design on Joint Line Position After Primary Total Knee Arthroplasty

2009 ◽  
Vol 24 (7) ◽  
pp. 1093-1098 ◽  
Author(s):  
Matthew G. Snider ◽  
Steven J. MacDonald
Keyword(s):  
Total Knee Arthroplasty ◽  
Posterior Cruciate Ligament ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Primary Total Knee Arthroplasty ◽  
Joint Line ◽  
Line Position ◽  
Component Design ◽  
Total Knee ◽  
Primary Total Knee

A Cam–Post Mechanism Is No Longer Necessary in Modern Primary Total Knee Arthroplasty

2019 ◽  
Vol 32 (08) ◽  
pp. 710-713 ◽  
Author(s):  
R. Michael Meneghini ◽  
Michael D. Stefl ◽  
W. Andrew Hodge ◽  
Scott A. Banks
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Primary Total Knee Arthroplasty ◽  
Conclusive Evidence ◽  
Clinical Difference ◽  
Medial Pivot ◽  
Total Knee ◽  
Primary Total Knee

AbstractConclusive evidence supporting a clinical difference between posterior-stabilized (PS) and cruciate-retaining (CR) designs in total knee arthroplasty (TKA) does not currently exist, despite both designs being used for decades. Proponents of PS designs that employ a cam-and-post mechanism cite in vivo fluoroscopic data that demonstrate improved posterior rollback; however, optimal rollback has never been correlated to superior clinical outcomes. Recently, anterior-lipped and more conforming CR bearings, such as ultracongruent, medial pivot, and dual-pivot designs, have been used to substitute for the posterior cruciate ligament and obviate the need for the cam–post mechanism of a traditional PS design. Advantages of avoiding a PS TKA include eliminating the risk of box cut induced femoral condylar fracture, improving operative efficiency by removing procedural steps, removing the articulation that is a source of wear, postdeformation, breakage, or dislocation, and eliminating patellar clunk. Health care reform efforts mandate cost reduction, and procedural efficiencies and minimizing inventory through the removal of unnecessary bearing options foster that initiative.

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