No Significant Differences in Clinical and Radiographic Outcomes between PCL Retained or Sacrificed Kinematic Aligned Medial Pivot Total Knee Arthroplasty in Varus Knee

Abstract

In the last decades, several surgical techniques, such as medial pivot (MP) philosophy and kinematic alignment (KA), have been introduced in total knee arthroplasty (TKA) to improve patients’ outcomes. This retrospective study aims to evaluate the clinical, radiographic, and functional results of PCL preservation or sacrifice in KA MP-TKA. A consecutive series of 147 patients older than 60, with a minimum follow-up of two years, were treated with TKA for severe primary knee osteoarthritis (OA) at the Department of Orthopedics and Traumatology between 1 January 2019, and 1 July 2020. After excluding those not meeting the inclusion criteria, 64 patients were included in the study analysis. Regarding radiographic outcomes, no statistically significant difference was observed between patients with preserved or sacrificed PCL (p > 0.05). A slight improvement in Knee Society Score (KSS), knee and function score, and FJS was observed for the PCL-preserved group, although this superiority tendency was not statistically significant (p > 0.05). PCL-preserved MA MP-TKA reported a statistically significant result in only two questions on the FJS questionnaire (p < 0.05). A slight, non-statistically significant improvement in active ROM was found in the PCL-sacrificed group (p > 0.05). No interventions or revisions were reported in this case series for all treated patients at the final follow-up. No significant differences were described in clinical, radiographic, and functional outcomes in preserved or sacrificed PCL KA MP-TKA. Although not significant, a slight trend toward better clinical outcomes was reported in PCL-preserved KA MP-TKA.

Calipered kinematic alignment restored the arithmetic hip–knee–ankle angle, achieved high satisfaction and improved clinical outcomes

“…These PROM results were similar to the present study. Whilst the FJS in the present study was less than Nedopil's cohort, the mean was higher in our study when compared to the unrestricted calipered groups of both PCL preserved and sacrificed in Giustra et al's [9] study. Other studies using technology‐based platforms to achieve KA showed similar results, including McEwen et al [25], who conducted a randomised controlled trial on computer‐assisted KA.…”

Is the Combination of Platelet-Rich Plasma and Hyaluronic Acid the Best Injective Treatment for Grade II-III Knee Osteoarthritis? A Prospective Study

“…Osteoarthritis is the most common disease of joints in the adult population [1][2][3][4]. In particular, the knee is the most frequent location for osteoarthritis, as its prevalence in adults is around 6%, rising as high as 40% among the 70-to-74-year-olds [5][6][7]. Knee osteoarthritis thereby represents a burden for national health systems, as it can lead to serious disability caused by increasing pain and progressive articular stifness that may limit patients' autonomy and thereby have a negative impact on their quality of life [8][9][10][11][12].…”

Clinical and Radiographic Outcomes of Inversed Restricted Kinematic Alignment Total Knee Arthroplasty by Asia Specific (Huang’s) Phenotypes, a Prospective Pilot Study

“…The purpose of TKA is restoring the native harmony of the knee. Three interdependent elements, including morphology, soft-tissue balance, and alignment, should be considered at the same time to reach this goal [ 29 , 30 ]. As shown in Figure 4 , MA, which solely focuses on alignment and ignores the other two elements, has a high ratio of dissatisfaction.…”