Evaluation of the relationship between anteroposterior translation of a posterior cruciate ligament-retaining total knee replacement and functional outcome

2012 ◽  
Vol 94-B (10) ◽  
pp. 1362-1365 ◽  
Author(s):  
R. B. Seah ◽  
H. N. Pang ◽  
N. N. Lo ◽  
H. C. Chong ◽  
P. L. Chin ◽  
...  
2012 ◽  
Vol 1 (4) ◽  
pp. 64-70 ◽  
Author(s):  
M. A. Ritter ◽  
K. E. Davis ◽  
J. B. Meding ◽  
A. Farris

2016 ◽  
Vol 29 (06) ◽  
pp. 484-490 ◽  
Author(s):  
Rebecca Howie ◽  
Timothy Foutz ◽  
Curtis Cathcart ◽  
Jeff Burmeister ◽  
Steve Budsberg

SummaryObjective: To investigate the relationship between tibiofemoral kinematics before and after total knee replacement (TKR) in vitro.Animals: Eight canine hemipelves.Methods: A modified Oxford Knee Rig was used to place cadaveric limbs through a range of passive motion allowing the kinematics of the stifle to be evaluated. Four measurements were performed: a control stage, followed by a cranial cruciate transection stage, then following TKR with the musculature intact stage, and finally TKR with removal of limb musculature stage. Joint angles and translations of the femur relative to the tibia, including flexion-extension versus adduction-abduction, flexion-extension versus internal-external rotation, as well as flexion-extension versus each translation (cranial-caudal and lateral-medial) were calculated.Results: Significant differences were identified in kinematic data from limbs following TKR implantation as compared to the unaltered stifle. The TKR resulted in significant decreases in external rotation of the stifle during flexion-extension compared to the limb prior to any intervention, as well as increasing the abduction. The TKR significantly increased the caudal translation of the femur relative to the tibia compared to the unaltered limb. When compared with the cranial cruciate ligament-transection stage, TKR significantly decreased the ratio of the external rotation to flexion.Discussion: All three test periods showed significant differences from the unaltered stifle. The TKR did not completely restore the normal kinematics of the stifle.


Author(s):  
Mohan M. Kumar ◽  
Satvik N. Pai ◽  
Pravin K. Vanchi ◽  
Raghav Ravi ◽  
Syam Nath

<p><strong>Background: </strong>The choice between preserving, sacrificing or substituting the posterior cruciate ligament (PCL) is always a controversial topic in total knee replacement (TKR). Dished polyethylene insert with PCL resection enables correction of the commonly present fixed flexion and varus deformities. Additionally, the risk of premature wear of polyethylene is less because of the confirming articular geometry between the femoral and tibial component.<strong></strong></p><p><strong>Methods: </strong>This is a retrospective study in which we studied 120 knees in 95 consecutive patients undergoing primary TKR by the senior author at our institute. We used TKR system with dished metal backed polyethylene tibial component. PCL resection was performed in all cases. Pre-operative and post-operative functional assessment were done using knee society clinical scores and Western Ontario and McMaster universities osteoarthritis index (WOMAC). All radiographs were assessed using the knee society Roentgenographic scoring system (KSRES). Statistical analysis was performed using paired student t tests. Survivorship was determined using Kaplan-Meier survivorship curves. <strong></strong></p><p><strong>Results: </strong>Mean follow-up was 8 years. Range of motion increased from 75 degrees to 110 degrees.  The knee society pain score increased from 30 to 94. The knee society function score increased from 35 to 75. WOMAC score increased in terms of pain, stiffness and physical function.<strong></strong></p><p><strong>Conclusions: </strong>We conclude that deep dish bearing is a viable option in presence of deficient PCL and provides adequate stability and functional outcome. We need a larger sample size, multicentre trial and longer follow-up to see for complication rate, revision rate and survival.</p>


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