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

Knee Surg Sports Traumatol Arthrosc. 2014 Dec;22(12):3113-20. doi: 10.1007/s00167-014-3200-5. Epub 2014 Jul 29.

Abstract

Purpose: The goal of this study was to compare three types of mobile-bearing posterior cruciate ligament (PCL)-sacrificing TKA. The hypothesis was that the three designs provide differences in flexion stability and femoral rollback and improved clinical score at 2-year follow-up.

Methods: Three groups of patients, divided according to implant design, were analysed retrospectively. All operations were guided by a non-image-based navigation system that recorded relative femoral and tibial positions in native and implanted knees during: passive range of motion and anterior drawer test at 90° flexion. WOMAC, KSS and SF36 scores were collected pre-operatively and at 2-year follow-up.

Results: There are no differences in kinematic or clinical performance of the three implants, except for the antero-posterior translation during stress test in flexion: only Cohort B had comparable pre- and post-operative laxity test values (p < 0.001). All three TKA designs allowed to maintain pre-operative tibial rotation pattern through all range of knee flexion. All clinical scores of the three patient cohorts were significantly improved post-operatively compared to the pre-operative values (p < 0.001). Moreover, we found no differences among post-operative results of the three designs.

Conclusion: Despite design variations, mobile-bearing PCL-sacrificing TKA reproduces femoral rollback and screw-home with little or no difference in clinical or functional scores at a follow-up of 2 years.

Level of evidence: III.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / adverse effects
  • Arthroplasty, Replacement, Knee / methods*
  • Biomechanical Phenomena
  • Female
  • Femur / physiopathology
  • Humans
  • Joint Instability / etiology
  • Joint Instability / prevention & control
  • Knee Prosthesis
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / surgery*
  • Posterior Cruciate Ligament / surgery*
  • Range of Motion, Articular
  • Retrospective Studies
  • Rotation
  • Tibia / physiopathology