Top

International Orthopaedics

Published in:

01-07-2016 | Original Paper

Retrospective comparative study shows no significant difference in postural stability between cruciate-retaining (CR) and cruciate-substituting (PS) total knee implant systems

Authors: Juergen Götz, Johannes Beckmann, Ingo Sperrer, Clemens Baier, Silvia Dullien, Joachim Grifka, Franz Koeck

Published in: International Orthopaedics | Issue 7/2016

Abstract

Purpose

Modified postural stability after retaining the posterior cruciate ligament (PCL) in total knee arthroplasty is still discussed controversially. The objective of this study was to evaluate whether a PCL-retaining implant design should be preferred over a PCL-substituting implant design regarding postural stability in one-leg stance and clinical outcome.

Methods

Forty patients underwent total knee arthroplasty, 20 of them with a cruciate-retaining (CR) and 20 of them with a cruciate-substituting (PS) implant system. Postural stability was analysed 6 months postoperatively in one-leg stance using the Biodex Balance System. In addition, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Knee Society Score were completed.

Results

This study shows that there is no significant difference in postural stability between CR and PS) implant systems with PS implants showing better results in WOMAC score.

Conclusions

In case it is necessary to use a PS implant, no negative influence on postural stability is to be expected compared to a CR implant.

Centers for Disease Control and Prevention (2015) FastStats – inpatient surgery http://www.cdc.gov/nchs/fastats/inpatient-surgery.htm. Accessed 8 Aug 2015

Verra WC, van den Boom LG, Jacobs W, Clement DJ, Wymenga AA, Nelissen RG (2013) Retention versus sacrifice of the posterior cruciate ligament in total knee arthroplasty for treating osteoarthritis. Cochrane Database Syst Rev 10:CD004803. doi:10.1002/14651858.CD004803.pub3 PubMed

Hunt NC, Ghosh KM, Blain AP, Rushton SP, Longstaff LM, Deehan DJ (2015) No statistically significant kinematic difference found between a cruciate-retaining and posterior-stabilised Triathlon knee arthroplasty: a laboratory study involving eight cadavers examining soft-tissue laxity. Bone Joint J 97-B(5):642–648. doi:10.1302/0301-620X.97B5.34999 CrossRefPubMed

Freeman MA, Pinskerova V (2005) The movement of the normal tibio-femoral joint. J Biomech 38(2):197–208CrossRefPubMed

Kapandji I (2006) Funktionelle Anatomie der Gelenke, vol 2, 4th edn. Thieme, Stuttgart, p 84

Bachmann M, Bolliger L, Ilchmann T, Clauss M (2014) Long-term survival and radiological results of the Duracon™ total knee arthroplasty. Int Orthop 38(4):747–752. doi:10.1007/s00264-013-2154-4 CrossRefPubMed

Yue B, Varadarajan KM, Rubash HE, Li G (2012) In vivo function of posterior cruciate ligament before and after posterior cruciate ligament-retaining total knee arthroplasty. Int Orthop 36(7):1387–1392. doi:10.1007/s00264-011-1481-6 CrossRefPubMedPubMedCentral

Dennis DA, Komistek RD, Mahfouz MR, Haas BD, Stiehl JB (2003) Multicenter determination of in vivo kinematics after total knee arthroplasty. Clin Orthop Relat Res 416:37–57CrossRefPubMed

Dennis DA, Komistek RD, Colwell CE Jr, Ranawat CS, Scott RD, Thornhill TS, Lapp MA (1998) In vivo anteroposterior femorotibial translation of total knee arthroplasty: a multicenter analysis. Clin Orthop Relat Res 356:47–57CrossRefPubMed

10.

Baier C, Fitz W, Craiovan B, Keshmiri A, Winkler S, Springorum R, Grifka J, Beckmann J (2014) Improved kinematics of total knee replacement following partially navigated modified gap-balancing technique. Int Orthop 38(2):243–249. doi:10.1007/s00264-013-2140-x CrossRefPubMed

11.

Zhang K, Mihalko WM (2012) Posterior cruciate mechanoreceptors in osteoarthritic and cruciate-retaining TKA retrievals: a pilot study. Clin Orthop Relat Res 470(7):1855–1859. doi:10.1007/s11999-011-2120-7 CrossRefPubMed

12.

Vandekerckhove PJ, Parys R, Tampere T, Linden P, Van den Daelen L, Verdonk PC (2015) Does cruciate retention primary total knee arthroplasty affect proprioception, strength and clinical outcome? Knee Surg Sports Traumatol Arthrosc 23(6):1644–1652. doi:10.1007/s00167-014-3384-8 CrossRefPubMed

13.

Swanik CB, Lephart SM, Rubash HE (2004) Proprioception, kinesthesia, and balance after total knee arthroplasty with cruciate-retaining and posterior stabilized prostheses. J Bone Joint Surg Am 86-A(2):328–334PubMed

14.

Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop 248:13–14PubMed

15.

Lingard EA, Katz JN, Wright RJ, Wright EA, Sledge CB, Kinemax Outcomes Group (2001) Validity and responsiveness of the Knee Society Clinical Rating System in comparison with the SF-36 and WOMAC. J Bone Joint Surg Am 83-A(12):1856–1864PubMed

16.

Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed

17.

Woollacott MH, Tang PF (1997) Balance control during walking in the older adult: research and its implications. Phys Ther 77:646–660PubMed

18.

Arnold BL, Schmitz RJ (1998) Examination of balance measures produced by the biodex stability system. J Athl Train 33(4):323–327PubMedPubMedCentral

19.

Finn JA, Alvarez MM, Jett RE, Axtell DS, Kemler DD (1999) Stability performance assessment among subjects of disparate balancing abilities. Med Sci Sports Exerc 31:S2529

20.

Sando T, McCalden RW, Bourne RB, MacDonald SJ, Somerville LE (2015) Ten-year results comparing posterior cruciate-retaining versus posterior cruciate-substituting total knee arthroplasty. J Arthroplasty 30(2):210–215. doi:10.1016/j.arth.2014.09.009 CrossRefPubMed

21.

Seon JK, Yim JH, Seo HY, Song EK (2013) No better flexion or function of high-flexion designs in Asian patients with TKA. Clin Orthop Relat Res 471(5):1498–1503. doi:10.1007/s11999-012-2629-4 CrossRefPubMed

22.

Luo SX, Zhao JM, Su W, Li XF, Dong GF (2012) Posterior cruciate substituting versus posterior cruciate retaining total knee arthroplasty prostheses: a meta-analysis. Knee 19(4):246–252. doi:10.1016/j.knee.2011.12.005 CrossRefPubMed

23.

Barrett DS, Cobb AG, Bentley G (1991) Joint proprioception in normal, osteoarthritic and replaced knees. J Bone Joint Surg Br 73:53–56PubMed

24.

Warren PJ, Olanlokun TK, Cobb AG, Bentley G (1993) Proprioception after knee arthroplasty. The influence of prosthetic design. Clin Orthop 297:182–187PubMed

Title: Retrospective comparative study shows no significant difference in postural stability between cruciate-retaining (CR) and cruciate-substituting (PS) total knee implant systems
Authors: Juergen Götz
Johannes Beckmann
Ingo Sperrer
Clemens Baier
Silvia Dullien
Joachim Grifka
Franz Koeck
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 7/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-015-3067-1

At a glance: The STEP trials

Springer Medicine

Retrospective comparative study shows no significant difference in postural stability between cruciate-retaining (CR) and cruciate-substituting (PS) total knee implant systems

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 7/2016

Clinical and radiographic outcomes of medial open-wedge high tibial osteotomy with Anthony-K plate: prospective minimum five year follow-up data

Influence of somatization and depressive symptoms on the course of pain within the first year after uncomplicated total knee replacement: a prospective study

Complications and rare cases in orthopaedics

Risk factors of post-operative malalignment in fixed-bearing medial unicompartmental knee arthroplasty

Stemless shoulder prosthesis for treatment of proximal humeral malunion does not require tuberosity osteotomy

Effect of centre-edge angle on clinical and quality of life outcomes after arthroscopic acetabular labral debridement