Evaluation of Postoperative Range of Motion and Functional Outcomes after Cruciate-Retaining and Posterior-Stabilized High-Flexion Total Knee Arthroplasty

Abstract

PurposeThe purpose of this study was to compare postoperative range of motion and functional outcomes among patients who received high-flexion total knee arthroplasty using cruciate-retaining (CR-Flex) and posterior-stabilized (PS-Flex) type prostheses.Materials and MethodsAmong 127 patients (186 knees) who underwent high-flexion total knee arthroplasty between 2005 and 2007, 92 knees were placed in the CR-Flex group, and 94 knees were placed in the PS-Flex group. After two years of postoperative follow-up, clinical and radiographic data were reviewed. Postoperative non-weight-bearing range of knee motion, angle of flexion contracture and functional outcomes based on the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) functional sub-scale were assessed and compared between the two groups.ResultsAfter the 2-year postoperative period, the mean range of motion was 131° in the CR-Flex group and 133° in the PS-Flex group. There were no significant differences in postoperative range of motion between the two groups. Only age at operation and preoperative range of motion were significantly associated with postoperative range of motion after high-flexion total knee arthroplasty. Postoperative functional outcomes based on the WOMAC functional sub-scale were slightly better in the CR-Flex group (9.2±9.1 points) than in the PS-Flex group (11.9±9.6 points); however, this difference was not statistically significant (p=non-significant).ConclusionThe retention or substitution of the posterior cruciate ligament does not affect postoperative range of motion (ROM) or functional outcomes, according to 2 years of postoperative follow-up of high-flexion total knee arthroplasty.

Outcomes of Posterior-Stabilized Compared with Cruciate-Retaining Total Knee Arthroplasty

“…It will be important for further research to focus on which particular populations, and not simply the overall TKA treated population, perform better with either the CR or PS method. Despite there being no statistically significant difference in KSOS or complications postoperatively for the 118 (19) 114 (15) 121 (18) 122 (10) Carvalho et al 52 (17) 89 (10) 47 (12) 90 (9) 55 (25) 81 (17) 51 (17) 76 (19) 106 (12) 97 (15) 106 (21) 114 (21) Cates et al 92.0 (10.5) 117 (15) 126 (9) 110 (17) 125 (10) Chaudhary 31 (14) 85 (12) 26 (15) 87 (8) 35 (16) 70 (27) 32 (13) 67 (28) 115 (11) 112 (11) 113 (16) 115 (10) Peters et al (2014) 36 53 (18) 92 (10) 52 (12) 88 (19) 56 (22) 85 (23) 58 (23) 81 ( 47 (17) 90 (12) 44 (11) 93…”

“…Even though a statistically significant difference in ROM between PS and CR groups was detected, both the underreporting of results and the difference in follow-up times may influence our results. For example, there were differences in the definition of postoperative, most reporting at 2 years 5,8,19,23,28,30,32,33,36,38,40,42,43,45 and some at 5 years. 2,3,9,14,17 Also, it is difficult to know at what time assessment was undertaken postoperatively for those who did not clarify their methods of follow-up.…”

“…Complications were reported in only 17 of the 37 studies (45.9%). 3,[5][6][7]14,19,20,22,28,30,32,33,[35][36][37]44,45 There was an overall complication rate of 3.9% (213 complications in 5,407 knees). The meta-analysis 3,6,20,22,29,35,45 showed that no statistical difference was found between the two procedures (95% CI, 0.78-2.31; p ¼ 0.29).…”

Kvalitet života pacijenata nakon implantacije totalne endoproteze koljena i medicinske rehabilitacije

“…Ovo je u suprotnosti sa rezultatima istraživanja [28] u kome je objašn-jenje za nedostatak superiornosti kod terapije jedan na jedan teorijsko. Prethodne studije su uočile da je odložena intenzivna terapija jedan na jedan bila povezana sa manjom, ali značajnijom koristi kod šestominutne šetnje i WOMAC-ovom funkcijom 6 mjeseci postoperativno u poređenju sa kućnom njegom.…”

Clinical Usefulness of the Staffelstein-Score in the Functional Assessment in Knee Arthroplasty Patients

“…Wy nik na po zio mie 46,5 pkt. był znacz nie ni ższy niż wy ni ki uzy ska ne przez in nych au to rów wśród osób ze zmia na mi zwy rod nie nio wy mi sta wu ko la no we go, któ re wa ha ły się od 53 do 71 punk tów [10][11][12][13]. Han i wsp.…”