Comparisonof early joint amnesia degree after posterior cruciate-retaining and posterior stabilized total knee arthroplasty / 中国组织工程研究

BACKGROUND: Clinical long-term follow-up showed that there is no obvious difference in knee range of motion, 10-15 year prosthesis survival rate, and main clinical manifestations after replacement of posterior cruciate-retaining and posterior stabilized prostheses. However, the debate over the superiority and inferiority of the two knee prostheses remains. OBJECTIVE: To compare the differences of early functional recovery of patients with unilateral knee osteoarthritis after posterior cruciate-retaining and posterior stabilized prosthesis replacement. METHODS: A total of 60 patients with knee osteoarthritis admitted to the First Affiliated Hospital of Anhui Medical University from July 2018 to September 2019 were selected, including 13 males and 47 females, aged 46-83 years old. Of them, 30 patients received posterior cruciate-retaining prosthesis replacement, and 30 patients received posterior stabilized prosthesis replacement. At 3 months after operation and at the last follow-up, joint amnesia score, knee function HSS score, visual analogue scale score, and knee motion range were assessed. The study was approved by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University. RESULTS AND CONCLUSION: (1) Sixty patients were followed up for 5-16 months, and no complications such as periprosthetic infection, loosening, dislocation, or stiffness occurred during the follow-up. (2) At 3 months after surgery and at the last follow-up, joint amnesia score, HSS scores, visual analogue scores, and knee motion range were not significantly different between the two groups (P > 0.05). (3) The results showed that joint amnesia score was not significantly different in early stage after the posterior cruciate-retaining and posterior stabilized prosthesis replacement for unilateral knee osthoarthritis.

Outcomes of the Different Types of Total Knee Arthroplasty with the Identical Femoral Geometry

PURPOSE: There are controversies around the role of the posterior cruciate ligament and the effect of design modifications for high flexion in total knee arthroplasty (TKA). So, we compared the clinical outcomes of the cruciate retaining (CR), posterior stabilized (PS), and high flexion posterior stabilized (F-PS) designs in TKA with identical femoral geometry. MATERIALS AND METHODS: One hundred seventy nine knees with 3 different types of prostheses after a minimum 5-year follow-up were enrolled in this retrospective study: 45 with CR, 40 with PS and 94 with F-PS. The mean ages of these groups were 65.7, 67.2, and 67.5, and the mean durations of follow-up were 8.1, 8.0, and 6.8 years, respectively. We compared the range of motion, functional outcomes, and radiographic measurements at the 2-year follow-up and last follow-up. RESULTS: The maximal flexion angle was significantly lower in the CR group than the F-PS group at the 2-year follow-up. However, there was no significant difference at the last follow-up. Functional outcomes and survival rate of the three groups were similar at the last follow-up. CONCLUSIONS: Three different types of TKAs (CR, PS and F-PS) with identical femoral geometry showed similar mid-term outcomes with regard to the range of motion, functional outcomes and survival rate.

Comparison of Posterior-Cruciate Retaining versus Substituting P.F.C. Total Knee Arthroplasty (A Randomized Study) / 대한정형외과학회잡지

PURPOSE: To compare the functional results of posterior cruciate-retaining (PCR) and posterior sub- stituting (PS) replacement in patients undergoing primary total knee arthroplasty (TKA) for osteoarthritis. MATERIALS AND METHODS: A randomized controlled study was carried out to compare the clinical and radiological outcomes of PCR and PS primary P.F.C.(R) TKA. One hundred and sixty eight patients (188 cases), who had a primary diagnosis of osteoarthritis, and an intact functioning posterior cruciate ligament, were enrolled in this study. The patients were randomized regardless of the level of posterior cruciate ligament preservation. One hundred and eighty eight cases had a minimum 6-year follow-up, which included 96 and 92 cases in the PCR and PS groups, respectively. RESULTS: The Knee Society Score, the Hospital for Special Surgery (HSS) knee rating scores, average flexion contracture and radiologic alignment improved significantly, but there were no significant difference between the two groups. On the other hand, the mean postoperative flexion angles in the PCR and PS knees increased from 114.7degrees to 121.2degrees and 119.3degrees to 131.3degrees, respectively (p<0.05). CONCLUSION: There were no significant differences between PCR and PS TKA in the follow-up knee scores. However, the level of postoperative improvement in further flexion was better in the PS group.

Results of Posterior Cruciate Retaining Total Knee Arthroplasty (3 to 8 years follow up) / 대한정형외과학회잡지

PURPOSE: To evaluate clinical results of posterior cruciate retaining TKA according to the preoperative range of motion (ROM), degree of deformity and obesity. MATERIALS AND METHODS: 81 cases were followed up more than 3 years. All cases were evaluated according to degree of preoperative ROM and varus deformity, presence of flexion contracture and BMI scale for obesity. Clinical and radiological evaluation systems were used with American knee society scale. RESULTS: Postoperative ROM according to the degree of preoperative ROM showed that the postoperative ROM in the good preoperative ROM group was better compared to the worse preoperative ROM groups and the results of knee scores showed the similar condition. Flex-ion contracture group revealed the better clinical results (p>0.05) compared to the group without contracture. The improvement of knee and functional scores was statistically significant in the more deformed varus groups and in the normal BMI group compared to the more obese groups. CONCLUSION: Good clinical results and satisfactory postoperative ROM are obtained by the good preoperative ROM, appropriate technique of maintaining adequate soft tissue balance in the deformed knee and preoperative weight control.