Short-term Results of Posterior Cruciate Sacrificing and Substitution Total Knee Arthroplasty

PURPOSE: To compare clinical and radiologic results after total knee arthroplasty (TKA) with posterior cruciate sacrificing (PCS) and posterior cruciate substitution (PS). MATERIALS AND METHODS: Of 66 knees in 53 patients with degenerative arthritis, we completed both practical and radiological evaluations for 27 patients with PCS TKA (30 knees) and 31 patients with PS TKA (36 knees). RESULTS: The knee score improved from 33 to 81.9 for PCS TKA and from 35 to 86.6 for PS TKA. Preoperative flexion was 104.5degrees in the PCS TKA group and 104.7degrees in the PS TKA group.These scores significantly improved to 113.9degrees and 104.7degrees respectively (p0.05). On radiological evaluation, the alpha angle was found to be 98.9degrees, the beta angle 89.9degrees , the gamma angle 5.0degrees, and the delta angle 39.2degrees for PCS TKA. Also, the alpha angle was 95.6degrees, beta angle 89.0degrees, gamma angle 9.0degrees, and delta angle 88.4degrees for PS TKA (p>0.05). Loosening was not encountered in either type. Postoperative complications were few; there was 1 knee (1.5%) with a polyethylene insert spin-out for the PCS TKA group and 1 knee (1.5%) with a periprosthetic fracture for the PS TKA group. CONCLUSION: On both clinical and radiological evaluations, PCS TKA and PS TKA demonstrated satisfactory results out to 4.5 years of follow up, which also indicated a lack of any significant difference between these two types.

Clinical Comparison of Posterior Cruciate Retained and Sacrificed in Mobile Bearing Total Knee Arthroplasty

PURPOSE: To evaluate the effect of posterior cruciate ligament retaining on clinical results in tota] knee arthroplasty. MATERIALS AND METHODS: Ninety-nine cases(80 patienis) of osteoarthritis were evaluated average 39 months(range 25-98 months) after total knee arthroplasty with LCS. the cases was divided into posterior cruciate retained group I(54 knees) and sacrificed group Il(45 knees). RESULTS: There was no statistically significant difference in H.S.S. knee score(I:87.4+/-6.3, II:86.1+/-5.7), range of motion(l:113.7 degrees +/- 19.8 degrees, II:111.9degrees +/-10.9 degrees), stability and roent- genographic findings, however, the functional score of the H.S.S. score was higher in group I(l: l8.2+/-5.6, II:15.3+/-4.5. p<0.05) and 6 patients with preoperative range of motion below 50 were in group II. 4 patients of 5 bilateral paired patients who ascended and descended stairs with one leg at a time prefer PCL retained side subjectively. CONCLUSION: We found no significant difference between group I and II in clinical results, however, might be that subjective symptom is excellent in group I and PCL sacrificed design seems to be effective in severely deformed knees and too tight PCL tension.