Three different cruciate-sacrificing TKA designs: minor intraoperative kinematic differences and negligible clinical differences

Bignozzi, S.; Zaffagnini, Stefano; Akkawi, Ibrahim; Marko, Tedi; Bruni, Danilo; Neri, Maria Pia; Colle, Francesca; Marcacci, Maurilio

doi:10.1007/s00167-014-3200-5

Cited by 18 publications

(24 citation statements)

References 41 publications

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“…Many studies have compared between TKAs with an UC insert and other design inserts. 9,11 –14,31,32 In terms of clinical outcomes, most of studies demonstrated similar results of UC design TKA with PS or CR, it is consistent with our study results. Multiple factors include geometry, implant size, type of insert, PCL integrity, and gap balancing are associated with AP instability in TKAs.…”

Section: Discussionsupporting

confidence: 92%

Similar outcomes between ultracongruent and posterior-stabilized insert in total knee arthroplasty: A propensity score-matched analysis

Lee

Yeom

Lee

et al. 2019

J Orthop Surg (Hong Kong)

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Purpose: (1) To compare postoperative range of motion (ROM), stability, and clinical outcomes between fixed-bearing posterior-stabilized (PS) and ultracongruent (UC). (2) The effect of postoperative stability on ROM and clinical outcomes was also evaluated in both designs. Materials and methods: Propensity score matching was conducted for age, gender, body mass index, preoperative ROM, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, Knee Society (KS) scores, hip–knee–ankle (HKA) alignment, and follow-up period. Two hundred patients (100 PS and 100 UC) were enrolled. Preoperative and final follow-up outcomes including postoperative ROM, anteroposterior (AP) stability (good, fair, and poor), WOMAC index, and KS scores were compared. Then, postoperative outcomes compared between the PS and UC. We also analyzed if AP stability was associated with the postoperative outcomes in both implant designs. Results: In both groups, ROM and clinical outcomes of final follow-up showed improvement than preoperation. Statistical significance was not determined between the PS and UC groups in terms of postoperative ROM (PS vs. UC, 134.6° vs. 133.4°, p = 0.13), stability (good/fair/poor, 91/9/0 vs. 84/14/0, p = 0.376), WOMAC index, KS scores, and outliers of HKA alignment (15% vs. 10%, p = 0.393). “Fair” stability showed inferior KS scores but greater ROM than “good” stability in both designs. Conclusion: TKA with UC insert provided similar ROM, AP stability, and clinical outcomes when compared to PS insert. In both designs, greater postoperative ROM was found but inferior clinical outcomes were found when TKA resulted in fair stability instead of good stability. Level of evidence III: Retrospective comparative study.

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Section: Discussionsupporting

confidence: 92%

Different intraoperative kinematics with comparable clinical outcomes of ultracongruent and posterior stabilized mobile-bearing total knee arthroplasty

Kim

Lee²,

Seong

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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“…Despite the kinematic differences, studies have found equivalent clinical outcomes between PS TKA and UC inserts. 47,49,50,55,56 Some studies have also shown that UC inserts have comparable clinical outcomes to cruciate retaining TKA. 54,57–59…”

Section: Ultracongruent Insertsmentioning

confidence: 99%

Sagittal radius of curvature, trochlea design and ultracongruent insert in total knee arthroplasty

Bloch

James

2019

EFORT Open Reviews

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Multi radius (MR) total knee arthroplasty (TKA) has been associated with mid-flexion instability. Single radius (SR) TKA may provide better anteroposterior stability through single flexion axis and biomechanical advantage for quadriceps function. Medial pivot (MP) TKA and gradually reducing (GR) radius TKA produce better knee kinematics. Clinical outcomes are equivalent for SR, MR and MP TKA. Short-term studies have shown better clinical outcomes and kinematics for GR TKA. Thinner and narrow anterior flange, deeper trochlea groove and more anatomical trochlea design reduces patellofemoral complications in TKA Ultracongruent inserts provide comparable clinical outcomes to posterior-stabilized TKA and cruciate retaining TKA.Cite this article: EFORT Open Rev 2019;4:519-524. DOI: 10.1302/2058-5241.4.180083

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Three different cruciate-sacrificing TKA designs: minor intraoperative kinematic differences and negligible clinical differences

Abstract: III.

Cited by 18 publications

References 41 publications

Similar outcomes between ultracongruent and posterior-stabilized insert in total knee arthroplasty: A propensity score-matched analysis

Similar outcomes between ultracongruent and posterior-stabilized insert in total knee arthroplasty: A propensity score-matched analysis

Different intraoperative kinematics with comparable clinical outcomes of ultracongruent and posterior stabilized mobile-bearing total knee arthroplasty

Sagittal radius of curvature, trochlea design and ultracongruent insert in total knee arthroplasty

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