Comparative Study of Posterior Stabilizing vs Cruciate Retaining Prosthesis in Total Knee Replacement

Abstract

Introduction: There has been a continuing debate regarding whether the posterior cruciate ligament should be sacrificed or retained at the time of total knee arthroplasty.It is still controversial which approach is superior because both cruciate retaining prosthesis and posterior stabilizing prosthesis have advantages and disadvantages. Materials and Methods: A cross sectional analytical study was conducted on 37 patients (20 in Posterior Stabilized group and 17 in Cruciate Retaining group) fulfilling the inclusion and exclusion criteria. The follow up was done at 1, 3 and 6 months during which functional outcome was compared using American Knee Society Score and associated complications were also compared. Results: At 6 months, the mean Knee Society Knee scores in Posterior Stabilized Group and Cruciate Retaining group were 91.05 ± 3.53 and 90.12 ± 3.57 respectively and mean Knee Society Functional scores were 89.75 ± 4.44 and 88.52 ± 4.24 respectively. The mean Knee Society Knee Score and Functional Score in both the groups were statistically not significant at pre-operative, 1 month, 3 months and 6 months as revealed by insignificant p value (>0.05). There were 3 complications in Posterior Stabilized Group which were 1 case of knee stiffness, 1 infection and 1 tibiofemoral subluxation. There were 2 complications in Cruciate Retaining Group which were 1 case of anterior knee pain and 1 periprosthetic proximal tibia fracture. Conclusions: Although, both the groups individually had significant improvement in regards to function from pre operative status to post operative status, there was no statistically significant difference in clinical and functional outcome between the two groups when compared with each other. However, the Posterior Stabilizing Total Knee Arthroplasty had better Range of motion score throughout the study. The complications associated with both the groups were comparable.