The influence of the posterior cruciate ligament in the maintenance of joint line in primary total knee arthroplasty

Cope, M.R.; O’Brien, Bill; Nanu, A.

doi:10.1054/arth.2002.29396

Cited by 46 publications

(35 citation statements)

References 6 publications

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“…From the information in the title, we excluded 876 references, and 46 references were excluded after examination of the abstract. For 9 references, we needed to examine the article in more detail to decide either that the outcome parameter or timing (1 study; Cope et al 2002) was not within the goal of the review, or that the randomization technique was not valid (8 studies; Dorr et al 1988, Vinciguerra et al 1994, Cash et al 1996, Laskin 1996, 1997, Simmons et al 1996, Stiehl et al 1997, Ishii et al 1998. This left 8 studies involving 576 patients in the review (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…A critical note has to be made on pooling data from separate studies. During the search, we found several studies which used inappropriate randomization techniques or did not claim to be randomized, and they were thus excluded (Dorr et al 1988, Becker et al 1991, Maloney and Schurman 1992, Hirsch et al 1994, Vinciguerra et al 1994, Cash et al 1996, Laskin 1996, Simmons et al 1996, Stiehl et al 1997, Ishii et al 1998, Pereira et al 1998, Udomkiat et al 2000, Cope et al 2002. In all of these studies, we cannot rule out selection bias, so the results should be interpreted with less certainty than the results from the meta-analysis and bestevidence synthesis.…”

Section: Discussionmentioning

confidence: 99%

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Retention versus removal of the posterior cruciate ligament in total knee replacement: A systematic literature review within the Cochrane framework

2005

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Background There is no consensus as to whether to use a posterior cruciate ligament (PCL) retaining design or a posterior-stabilized design for total knee arthroplasty. The objective of this study was to establish the difference in functional, clinical, and radiological outcome between retention and removal of the PCL. MethodsWe conducted a search in Medline, EMBASE, the Cochrane database, and Current Contents, along with reference checks and citation tracking. Randomized controlled trials were selected and methodological quality was assessed with the van Tulder and Jadad checklists by 2 independent reviewers.Results We found 8 randomized controlled trials. 2 treatment options were compared against PCL retention: PCL removal without post and cam mechanism (2 studies), and posterior-stabilized design (5 studies). 1 study included all 3 options. Range of motion was found to be 8° higher (105° vs. 113°) in the posterior-stabilized group compared to the PCL retention group (p = 0.01, 95% CI (1.7, 15)).Interpretation These results should be interpreted with caution, as the methodological quality of the studies was highly variable. Suggestions are given to improve future research on this specific aspect of knee arthroplasty.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Retention versus removal of the posterior cruciate ligament in total knee replacement: A systematic literature review within the Cochrane framework

2005

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“…Probably the difference observed in our study depends on the sparing of the PCL in Selvarajah series. In fact, when the release of the PCL is performed in conjunction with a medial or lateral release as in our series, it is possible to observe an increase in the gaps [14][15][16], which could lead to an elevation of the joint line. Another possible explanation of the difference could be based on the difference in the landmarks used for the joint line evaluation.…”

Section: Discussionmentioning

confidence: 89%

“…Another possible explanation of the difference could be based on the difference in the landmarks used for the joint line evaluation. In the Cope's series [16], who studied the influence of the posterior cruciate ligament in the maintenance of joint line, the post-operative mean height of the joint line was 2.5 cm in the PCL-retaining group and 2.4 cm in the PCL-substituting group, whereas the preoperative mean height of the joint line was 2.2 cm for the two groups. These values are more close to those observed in our series with a low difference that could be explained with the different method of measurement.…”

Section: Discussionmentioning

confidence: 99%

Gap balancing versus measured resection technique using a mobile-bearing prosthesis in computer-assisted surgery

et al. 2011

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Navigation has been developed to help surgeons install implants more accurately and reproducibly; at the same time, this tool is able to record quantitative information such as joint range of motion, laxity and kinematics intra-operatively. As for standard surgery, two strategies are possible to achieve either femoral component rotation or overall prosthetic alignment: a measured gap resection approach, in which bone landmarks are used to guide resections equal to the distal and posterior thickness of the femoral component, or a gap-balancing technique, in which equal collateral ligament tension in flexion and extension is tried to find before as a guide to final bone cuts. The purpose of this paper is to compare the two different methods in a 67 patients group submitted to the same procedure using mobile-bearing (MB) prosthesis in order to analyse the effect of both techniques on joint line maintenance, axial limb restoration and components position. The gap group (GG) consists of 31 patients in whom the arthroplasty was performed using a navigated gap-balancing technique. The measured group (MG) consists of 36 patients in whom a computer-assisted measured resection technique was used. The results of imaging and the number of outliers were not statistically different (P = 0.56) for the mechanical axis and prosthetic positioning between the two groups. The gap technique showed a statistically significant alteration of the post-operative value when compared with the measured resection technique, (P = 0.036). The mean elevation of the joint line was 4.09 mm for the GG and 3.50 mm in the MG.

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“…Large deviation of the joint line after TKA may result in decreased knee flexion, patellofemoral pain due to altered transmission of quadriceps forces, midflexion instability, decreased functional scores, and increased incidence of revisions and manipulations [4][5][6][7][8]. Figgie et al.…”

Section: Introductionmentioning

confidence: 99%

Computer guided restoration of joint line and femoral offset in cruciate substituting total knee arthroplasty

2012

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The influence of the posterior cruciate ligament in the maintenance of joint line in primary total knee arthroplasty

Cited by 46 publications

References 6 publications

Retention versus removal of the posterior cruciate ligament in total knee replacement: A systematic literature review within the Cochrane framework

Retention versus removal of the posterior cruciate ligament in total knee replacement: A systematic literature review within the Cochrane framework

Gap balancing versus measured resection technique using a mobile-bearing prosthesis in computer-assisted surgery

Computer guided restoration of joint line and femoral offset in cruciate substituting total knee arthroplasty

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