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Dysfunction of the posterior cruciate ligament in total knee arthroplasty.

Arbuthnot, James Edmund and Wainwright, Olwyn and Stables, Gareth and Rathinam, Manickam and Rowley, David I and McNicholas, Michael J (2011) Dysfunction of the posterior cruciate ligament in total knee arthroplasty. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 19 (6). pp. 893-8. ISSN 1433-7347. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids

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Abstract

PURPOSE

Total knee arthroplasty (TKA) is typically carried out either with retention (CR) of the posterior cruciate ligament (PCL) or with sacrifice of this ligament and implantation of a posterior stabilised (PS) prosthesis. This paper investigates a comparison of PCL function in knees treated for osteoarthritis with TKA where the PCL is preserved to those knees treated with TKA and posterior stabilisation.

METHODS

One hundred and sixty-eight patients (232 knees) who had undergone TKA with either a PS or CR implant were included in the study. Clinical assessment included antero-posterior (AP) laxity and posterior sag assessment with an arthrometer.

RESULTS

The mean AP laxity at 90° of flexion for CR TKAs was 6.5 mm (±3.1) and was the same [6.5 mm (±2.4)] as in the PS group. However, 56% of the PCL-preserved knees had a posterior sag of over 3 mm compared to 18% of the knees in the PS group. The American Knee Society Scores for either group showed that, although the mean function score was the same, the knee score was superior in the PS group (77 vs. 84). The range of motion was also superior in the PS group (111° vs. 105°).

CONCLUSION

The use of the PS prosthesis for TKA provides a more predictable outcome with regard to posterior sag and a better maximum flexion than a CR implant.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids
Subjects: WE Musculoskeletal. Orthopaedics
Divisions: Planned IP Care > Trauma and Orthopaedics
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 27 Jun 2014 13:09
Last Modified: 27 Jun 2014 13:09
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/388

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