Comparison of Contact Kinematics in Posterior-Stabilized and Cruciate-Retaining Total Knee Arthroplasty at Long-Term Follow-Up

There is controversy regarding the superiority of posterior-stabilizing (PS) total knee arthroplasty (TKA) and cruciate-retaining (CR) TKA. Substantial work has made comparisons between PS and CR TKA at follow-ups of less than 5 years. It was the goal of the present study to compare the kinematics a...

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Bibliographic Details
Published in:The Journal of arthroplasty Vol. 35; no. 1; pp. 272 - 277
Main Authors: Broberg, Jordan S., Ndoja, Silvio, MacDonald, Steven J., Lanting, Brent A., Teeter, Matthew G.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.01.2020
Subjects:
cruciate-retaining
kinematics
patient function
posterior-stabilized
radiostereometric analysis
total knee arthroplasty
total knee arthroplasty
cruciate-retaining
kinematics
radiostereometric analysis
patient function
posterior-stabilized
ISSN:0883-5403, 1532-8406, 1532-8406
Online Access:Get full text
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Summary:There is controversy regarding the superiority of posterior-stabilizing (PS) total knee arthroplasty (TKA) and cruciate-retaining (CR) TKA. Substantial work has made comparisons between PS and CR TKA at follow-ups of less than 5 years. It was the goal of the present study to compare the kinematics at greater than 5 years postoperatively between CR and PS TKA, with a secondary goal of comparing patient function. A total of 42 knees were investigated, with equal representation in the PS and CR TKA groups. Patients underwent radiostereometric analysis imaging at 0°, 20°, 40°, 60° 80°, and 100° of flexion. Contact position, magnitude of excursion, and condylar separation on each condyle were measured. A Timed-Up-and-Go functional test was also performed by patients, with the total test time being measured. Preoperative and postoperative clinical outcome scores were also collected. There were differences in contact position on both the medial and lateral condyles at multiple angles of flexion (P < .05). There was no difference (P = .89) in medial excursion; however, PS TKA had greater lateral excursion than CR TKA (P < .01). No difference (P > .99) was found in frequency of condylar separation. PS TKA was associated with faster (P = .03) total Timed-Up-and-Go test times. There were no differences in clinical outcome scores between the groups preoperatively or postoperatively. We found kinematic and functional differences that favor PS TKA. Our results suggest posterior cruciate ligament insufficiency in CR TKA, indicating that perhaps the cam/post systems in PS TKA better maintain knee kinematics and function long term.
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ISSN:0883-5403
1532-8406
1532-8406
DOI:10.1016/j.arth.2019.07.046