Posterior cruciate-retaining versus posterior stabilized total knee arthroplasty

Abstract

Background: Some surgeons decide to preserve or sacrifice PCL preoperatively based on their experience and training, while others decide intraoperatively after evaluating morphology of PCL, knee alignment, range of motion (ROM) and stability of knee. Several papers have been published comparing outcomes of PCL-retaining and PCL-stabilizing types of prostheses in neutrally aligned knees. Some potential advantages of cruciate-retaining prosthetic designs include preservation of bone, more normal knee kinematics, increased proprioception, femoral rollback on the tibia during flexion, and greater stabilization of the prosthesis, with the PCL preventing anterior translation of the femur on the tibia. Aim of the study: To compare posterior cruciate-retaining versus posterior stabilized total knee arthroplasty. Materials and methods: For the study, a total of 60 patients underwent total knee arthroplasty utilizing a posterior-stabilized prosthesis, and another group of 60 patients received a cruciate-retaining implant. All patients who had osteoarthritis, osteonecrosis, or rheumatoid arthritis and who were indicated for a total knee arthroplasty were invited to take part in a prospective study to follow their outcomes. The patients were evaluated in the office one month after the procedure and annually thereafter. The ranges of motion, Knee Society scores, radiographic outcomes, and complications were assessed at each follow-up visit, and these were compared at the five-year follow up. Results: We observed that the mean Knee Society knee scores of the Group 1 was 80 and for Group 2 was 75. The mean Knee Society functional scores were 67 points for Group 1 and 78 for Group 2. The mean ranges of motion were 132° for Group 1 and 125° for the for Group 2. The results on comparison were found to be statistically non-significant. Conclusion:Within the limitations of the present study, it can be concluded that posterior cruciateretaining versus posterior stabilized total knee arthroplasty offers significant benefits postoperatively; however, on comparing both the procedures provide similar results.