Posterior Cruciate Ligament Retention versus Posterior Stabilization for Total Knee Arthroplasty: A Meta-Analysis

Jiang, Chao; Liu, Zhenlei; Wang, Ying; Bian, Yanyan; Feng, Bin; Weng, Xi-sheng

doi:10.1371/journal.pone.0147865

Cited by 90 publications

(60 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…32,33 Jiang et al conducted a meta-analysis which showed PS TKA had a better knee flexion postoperatively. 34 Our study also had increased ROM in PS knees compared to CR knees.…”

Section: Cr Versus Pssupporting

confidence: 54%

See 1 more Smart Citation

Factors determining the range of motion in primary total knee arthroplasty

et al. 2019

View full text Add to dashboard Cite

Background: Total knee arthroplasty (TKA) is one of the most successful surgical procedure with over 90% survival rate at 10 to 15 years. It provides a stable, pain free range of motion (ROM) for day to day activities. The aim of this study is to evaluate various factors determining ROM after TKA.Methods: 348 patients with 390 knees treated with TKA using cruciate retaining (CR) and posterior stabilized (PS) prosthesis were included and analysed. Mean follow up period was 18 months. Patients were analysed for factors like age, sex, diagnosis, body mass index (BMI), pre-operative exercises, ROM, deformity, posterior femoral condylar offset (PFCO), posterior tibial slope (PTS), post-operative rehabilitation and implant design (CR vs PS). Statistical analysis of above factors on knee ROM was done. Patients were assessed pre-operatively, at 6 weeks, 3, 6, 12 and 18 months post-operatively.Results: Age and sex did not affect the final ROM. The mean knee ROM improved from 86.87° to 96.95°. Factors like BMI, deformity had negative correlation and Pre-operative diagnosis, exercises, knee scores, good preoperative ROM, PFCO, PTS had positive correlation on ROM.Conclusions: Pre-operative exercises, diagnosis, ROM, deformity, BMI, PFCO and PTS were important factors which influence ROM in TKA. Patient selection and preoperative counselling are important for good clinical outcome.

show abstract

“…32,33 Jiang et al conducted a meta-analysis which showed PS TKA had a better knee flexion postoperatively. 34 Our study also had increased ROM in PS knees compared to CR knees.…”

Section: Cr Versus Pssupporting

confidence: 54%

“…The patients in the OA category had good postop ROM (p<0.01) ( Figure 1). Mean BMI was 27.23 kg/m 2 (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). Highest BMI 37.34 kg/m 2 and lowest BMI 21.32 kg/m 2 .…”

Section: Resultsmentioning

confidence: 99%

Factors determining the range of motion in primary total knee arthroplasty

et al. 2019

View full text Add to dashboard Cite

show abstract

“…As to the choice of surgical technique between CR TKA and PS TKA, a recent meta-analysis collecting 14 Randomized Clinical Trials (RCTs) concluded that there is no clinical-relevant difference between CR TKA and PS TKA in terms of radiological and clinical outcomes, while PS TKA is superior to CR TKA with respect to range of motion (ROM), 13 which might be the result of increased flexion gap and decreased varus angle after PCL sacrifice. One more reason that CR TKA is not preferred is that most of the PCL insertion is likely to be sacrificed fully or partially during preparation of the tibial plateau, 14,15 which will potentially influence the clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of posterior cruciate ligament in total knee arthroplasty

Chen

Nagamine

2017

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Introduction: It has been realized that for osteoarthritis (OA) knee with varus deformity, posterior cruciate ligament (PCL) release resulted in the increase of the flexion gap without significant effect on the extension gap. While the effect of release on gap angle is still obscure. On the other hand, gap distance and varus angle measured under different distraction forces suggest different patterns. Objectives: In the current study, mechanical gap balance in displacement and angular alternation of extension and flexion gaps will be evaluated, with PCL fully retained or resected under different distracting forces in varus knees. Methods: Fifty cases with medial OA undergoing posterior-stabilized (PS) total knee arthroplasty (TKA) were included in the study. PCL of all the cases were identified intact before resection. After distal femoral and proximal tibial cuts were initially performed and anterior cruciate ligament was excised, joint gap angle and distance in full extension and at 90 flexion were obtained by means of a tensioning device with 10, 20 and 30 inch-pounds (in-lbf) of distraction force. The gap angle and distance were measured three times at each step. After the excision of PCL, the same measurement was performed. Results: Both the distance and the varus angles of the knee gap enlarged accordingly with the augment of distraction forces at both extension and flexion with or without PCL resection. As to the gap distance, it remained the same after PCL resection at extension; while at flexion, the gap distance significantly (p < 0.001) enlarged -1.2, 1.6 and 1.9 mm -under 10, 20 and 30 in-lbf, respectively, after PCL resection. As to the varus angles, it significantly (p < .050) decreased 0.6 , 0.3 and 0.4 at extension; while at flexion, the varus angles decreased 0 (not significant), 0.6 (p < 0.050) and 1.1 (p < 0.001) with 10, 20 and 30 in-lbf, respectively, after PCL resection. Conclusion: Our study indicated that the sacrifice of PCL will decrease the varus deformity at both extension and flexion, but with the exception under low distraction force at flexion. A proper distraction tension is of great importance in gap balancing during TKA. Sufficient attention of varus differences should be paid to the gap balance technique when choosing from different techniques, PCL-retained TKA or PCL-sacrificed TKA, as well as and an appropriate distract tension during measurement.

show abstract

“…However, generally, no statistical differences in terms of functional and clinical parameters were detected in the previous literature. Nevertheless, the superiority of one of the prosthesis types remains controversial [57–59]. Data extracted from the transverse and frontal plane should be interpreted with caution due to its known sources of measurement and modeling issues [29,60].…”

Section: Discussionmentioning

confidence: 99%

Non-Sagittal Knee Joint Kinematics and Kinetics during Gait on Level and Sloped Grounds with Unicompartmental and Total Knee Arthroplasty Patients

et al. 2016

View full text Add to dashboard Cite

After knee arthroplasty (KA) surgery, patients experience abnormal kinematics and kinetics during numerous activities of daily living. Biomechanical investigations have focused primarily on level walking, whereas walking on sloped surfaces, which is stated to affect knee kinematics and kinetics considerably, has been neglected to this day. This study aimed to analyze over-ground walking on level and sloped surfaces with a special focus on transverse and frontal plane knee kinematics and kinetics in patients with KA. A three-dimensional (3D) motion analysis was performed by means of optoelectronic stereophogrammetry 1.8 ± 0.4 years following total knee arthroplasty (TKA) and unicompartmental arthroplasty surgery (UKA). AnyBody™ Modeling System was used to conduct inverse dynamics. The TKA group negotiated the decline walking task with reduced peak knee internal rotation angles compared with a healthy control group (CG). First-peak knee adduction moments were diminished by 27% (TKA group) and 22% (UKA group) compared with the CG during decline walking. No significant differences were detected between the TKA and UKA groups, regardless of the locomotion task. Decline walking exposed apparently more abnormal knee frontal and transverse plane adjustments in KA patients than level walking compared with the CG. Hence, walking on sloped surfaces should be included in further motion analysis studies investigating KA patients in order to detect potential deficits that might be not obvious during level walking.

show abstract

Posterior Cruciate Ligament Retention versus Posterior Stabilization for Total Knee Arthroplasty: A Meta-Analysis

Cited by 90 publications

References 24 publications

Factors determining the range of motion in primary total knee arthroplasty

Factors determining the range of motion in primary total knee arthroplasty

Comparative evaluation of posterior cruciate ligament in total knee arthroplasty

Non-Sagittal Knee Joint Kinematics and Kinetics during Gait on Level and Sloped Grounds with Unicompartmental and Total Knee Arthroplasty Patients

Contact Info

Product

Resources

About