Retention versus sacrifice of the posterior cruciate ligament in total knee arthroplasty for treating osteoarthritis

Verra, Wiebe C.; Boom, Lennard G H van den; Jacobs, Wilco C. H.; Clement, Darren; Wymenga, A. B.; Nelissen, Rob G H H

doi:10.1002/14651858.cd004803.pub3

Cited by 71 publications

(81 citation statements)

References 61 publications

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“…From a Cochrane systematic review and a recent meta-analysis on this topic [13,24], this greater flexion would be in concordance with an increased ROM seen in patients who use a PS design compared with a PCR design. However, little is known about whether this observed increase in flexion in the PS design after TKA is also expressed during walking, one of the most routine daily activities.…”

Section: Introductionmentioning

confidence: 61%

No difference in gait between posterior cruciate retention and the posterior stabilized design after total knee arthroplasty

Boom

Halbertsma

Raaij

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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No difference in gait between posterior cruciate retention and the posterior stabilized design after total knee arthroplasty van den Boom, Lennard G. H.; Halbertsma, Jan P. K.; van Raaij, Jos J. A. M.; Brouwer, Reinoud W.; Bulstra, Sjoerd K.; van den Akker-Scheek, Inge Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. assess knee joint kinematics and kinetics during the loading response of the stance phase. Results no significant differences in maximum knee flexion between the two groups were found during the loading response of the stance phase. no significant differences in knee flexion moments were found either. Although in both groups knee flexion moments increased postoperatively, this was not statistically significant. In the contralateral (nonimplanted) knees, all mean knee flexion moments decreased postoperatively for both groups, yet this was not significant. Conclusions The present gait analysis study showed no differences in kinematics and kinetics between the PS and the PCR TKP design. This might suggest that surgeons do not necessarily need to substitute the PCL by a PS design during TKA. Level of evidence Prospective comparative study, Level II.

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Section: Introductionmentioning

confidence: 61%

No difference in gait between posterior cruciate retention and the posterior stabilized design after total knee arthroplasty

Boom

Halbertsma

Raaij

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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“…On the other side, in 2012, Li et al [14] in a meta-analysis of randomized controlled trials, compared the 2 types of knee prosthesis and reported similar outcomes in postoperative knee pain, function, complications and prosthesis survivorship. Finally, the meta-analysis of randomized and quasi-randomized controlled trials by Verra et al [15] in 2013, confirmed that there was no difference between posterior-stabilized and posterior-retained TKA regarding pain, and clinical and radiological outcomes, despite the fact that the range of motion and Knee Society Score were found higher with the former type.…”

Section: Retaining Tkamentioning

confidence: 91%

“…Verra et al [15] Meta-analysis of randomized and quasi-randomized controlled trials, comparing retention with sacrifice of the PCL in primary TKR…”

Section: Ref Type Of Study Outcomementioning

confidence: 99%

Common controversies in total knee replacement surgery: Current evidence

Nikolaou¹

2014

WJO

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Total knee replacement (TKR) is a widely used operation that has radically improved the quality of life of millions of people during the last few decades. However, some technical details, concerning the surgical procedure and the rehabilitation following total knee arthroplasty, are still a matter of a strong debate. In this review of the literature, we have included the best evidence available of the last decade, in an effort to shed light on some of the most controversial subjects related to TKR surgery. Posterior-stabilized or cruciate-retaining prosthesis? To use a tourniquet during operation or not? Do patients need continuous passive motion for their post-surgery rehabilitation? To resurface patella or not? These are some of the most controversial topics that until now have been persistent dilemmas for the orthopedic surgeon. Results of this systematic review of the literature are highly controversial. These conflicting results are an indication that larger and more well conducted high quality trials are needed in order to gain more secure answers. At the same time, it is becoming apparent that a meticulous operative technique, respecting the soft tissue envelope and knowing the principles of alignment and soft tissue balancing, are some of the parameters that might contribute more to achieving the optimal results for the patients. Key words: Total knee replacement; Controversy; Literature review; Patella resurfacing; Patella eversion; Posterior stabilized; Cruciate retaining; Tourniquet; Continuous passive motion Core tip: A literature review has been conducted in an effort to present the best available evidence of the last decade and to shed light on some of the most controversial subjects related to total knee replacement surgery. Patella resurfacing or not? Posterior cruciate retaining or sacrificing? Continuous passive motion or not? Tourniquet or not? These are some of the most debatable topics that until now have been persistent dilemmas for the orthopedic surgeon. Results of this systematic review of the literature are highly controversial. These conflicting results are an indication that larger and better conducted high quality trials are needed in order to gain more secure answers.Nikolaou VS, Chytas D, Babis GC. Common controversies in total knee replacement surgery: Current evidence. World J Orthop 2014; 5(4

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“…no clinical superiority of one type has been proven in the past, and overall survival for both types of prostheses is good [27].…”

Section: Introductionmentioning

confidence: 99%

Post-cam mechanics and tibiofemoral kinematics: a dynamic in vitro analysis of eight posterior-stabilized total knee designs

Arnout

Vanlommel

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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ResultsThe post-cam mechanisms analyzed in this study are very variable in terms of design features. This leads to large variations in terms of the flexion angle at which the post and cam engage maximal contact force, contact pressure and contact area. We found that more functional postcam mechanisms, which engage at lower flexion angle and have a similar behavior as normal PCL function, generally show more normal rollback and tibial rotation at the expense of higher contact forces and pressures. All designs show high contact forces. A positive correlation was found between contact force and initial contact angle. Conclusion Post-cam contact mechanics and kinematics were documented in a standardized setting. Post-cam contact mechanics are correlated with post-cam function. Outcomes of this study can help to develop more functional designs in future. nevertheless, a compromise will always be made between functional requirements and risk of failure. We assume that more normal knee kinematics leads to more patient satisfaction because of better mobility. Understanding of the post-cam mechanism, and knowing how this system really works, is maybe the clue in further development of new total knee designs.

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Retention versus sacrifice of the posterior cruciate ligament in total knee arthroplasty for treating osteoarthritis

Cited by 71 publications

References 61 publications

No difference in gait between posterior cruciate retention and the posterior stabilized design after total knee arthroplasty

No difference in gait between posterior cruciate retention and the posterior stabilized design after total knee arthroplasty

Common controversies in total knee replacement surgery: Current evidence

Post-cam mechanics and tibiofemoral kinematics: a dynamic in vitro analysis of eight posterior-stabilized total knee designs

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