Retention of the posterior cruciate ligament versus the posterior stabilized design in total knee arthroplasty: a prospective randomized controlled clinical trial

Background and purpose — The preference for a cruciate retaining (CR) or posterior stabilized (PS) TKA (total knee arthroplasty) system varies greatly between Dutch hospitals, independent of patient characteristics. We examined mid-term revision rates for men and women of different age categories.Patients and methods — We included all 133,841 cemented fixed-bearing primary CR or PS TKAs for osteoarthritis reported in the Dutch Arthroplasty Register (LROI) in 2007–2016. Revision procedures were defined as minor when only insert and/or patella were revised and as major when fixed components (tibia and femur) were revised or removed. 8-year all-cause revision rates of CR and PS TKAs were calculated using competing-risk analyses. Cox-regression analyses were performed, adjusted for age at surgery, sex, ASA -score, and previous operations.Results — PS TKAs were 1.5 (95% CI 1.4–1.6) times more likely to be revised within 8 years of the primary procedure, compared with CR TKAs. When stratified for sex and age category, 8-year revision rate of PS TKAs in men <60 years was 13% (CI 11–15), compared to 7.2% (CI 6.1–8.5) of CR TKAs. Less prominent differences were found in older men and women. For men <60 years differences were found for minor (CR 1.8% (CI 1.4-2.5); PS 3.7% (CI 3.0–4.7)) and major revisions (CR 4.2% (CI 3.3–5.3); PS 7.0% (CI 5.6–8.7)).Interpretation — Patients who received a cemented fixed-bearing primary PS TKA for osteoarthritis are more likely to undergo either a minor or a major revision within 8 years. This is especially prominent for younger men.

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“…2005, van den Boom et al. 2009). In the literature, there is no consensus regarding the outcome of CR compared with PS TKAs.…”

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confidence: 99%

Higher mid-term revision rates of posterior stabilized compared with cruciate retaining total knee arthroplasties: 133,841 cemented arthroplasties for osteoarthritis in the Netherlands in 2007–2016

et al. 2018

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“…Two typical types either substitute for a resected posterior cruciate ligament or allow its preservation [3,23], and the survivorship rates for the two designs are similar [13,20,23]. However, many surgeons prefer posterior stabilized knee prostheses to correct moderate to severe deformities.…”

Section: Introductionmentioning

confidence: 99%

High Early Failure Rate of the Columbus® Posterior Stabilized High-flexion Knee Prosthesis

Jung

Jeong

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Most studies report high survivorship rates for TKAs, however, we observed higher than anticipated rates of dislocation and femoral component loosening after implanting a Columbus 1 posterior stabilized prosthesis. Questions/purpose We therefore determined (1) the incidence of dislocation and aseptic loosening that occurred after implantation of posterior stabilized high-flexion prostheses in TKAs, (2) the causative factors of dislocation and aseptic femoral component loosening when comparing two designs of prostheses, and (3) the mechanisms of dislocation. Methods We retrospectively reviewed 319 patients who underwent

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“…TKA has presented excellent results with survival rates greater than 90% in follow-ups longer than 10 and 20 years. 28 The patient satisfaction rate after TKA is high (90%) and 93% of the patients would undergo this procedure again. 29 The QoL results demonstrated that TKA presents an excellent cost/benefit relationship and analysis on published studies shows that it is a highly effective procedure, with favorable results from surgical interventions.…”

Section: Discussionmentioning

confidence: 99%

Quality-of-life assessment among patients undergoing total knee arthroplasty in Manaus

Leão

Santoro

Avelino

et al. 2014

Revista Brasileira de Ortopedia (English Edition)

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Objectivethis study had the aim of assessing the quality of life among patients undergoing total knee arthroplasty (TKA). For this, the SF-36 and WOMAC questionnaires respectively were used to make comparisons with preoperative values.Methodsa prospective observational cohort study was conducted, with blinded analysis on the results from 107 TKAs in 99 patients, between June 2010 and October 2011. The present study included 55 knees/patients, among whom 73% were female and 27% were male. The patients’ mean age was 68 years. The SF-36 and WOMAC questionnaires (which have been validated for the Portuguese language) were applied immediately before and six months after the surgical procedure.Resultsthe statistical and graphical analyses indicated that the variables presented normal distribution. From the data, it was seen that all the indices underwent positive changes after the surgery.Conclusionsdespite the initial morbidity, TKA is a very successful form of treatment for severe osteoarthritis of the knee (i.e. more than two joint compartments affected and/or Ahlback classification greater than 3), from a functional point of view, with improvement of the patients’ quality of life, as confirmed in the present study. This study presented evidence level IV (description of case series), with analysis on the results, without a comparative study.

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Retention of the posterior cruciate ligament versus the posterior stabilized design in total knee arthroplasty: a prospective randomized controlled clinical trial

Cited by 28 publications

References 12 publications

Higher mid-term revision rates of posterior stabilized compared with cruciate retaining total knee arthroplasties: 133,841 cemented arthroplasties for osteoarthritis in the Netherlands in 2007–2016

Higher mid-term revision rates of posterior stabilized compared with cruciate retaining total knee arthroplasties: 133,841 cemented arthroplasties for osteoarthritis in the Netherlands in 2007–2016

High Early Failure Rate of the Columbus® Posterior Stabilized High-flexion Knee Prosthesis

Quality-of-life assessment among patients undergoing total knee arthroplasty in Manaus

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