Impact of anterior stabilized insert on primary total knee arthroplasty (TKA) with an incompetent posterior cruciate ligament (PCL)
Journal Title: International Journal of Orthopaedics Sciences - Year 2018, Vol 4, Issue 1
Abstract
Background: The role of posterior cruciate ligament (PCL) conservation and the choice of the level of constraint of polyethylene insert in total knee arthroplasty (TKA) are still debated. The use of anterior stabilized bearing has been associated with clinical success in a limited number of studies. We have used anterior stabilized bearing and studied its impact in case of lose or deficient PCL. Material and Methods: A prospective study of 100 total knee arthroplasty to evaluate the impact of anterior stabilized bearing in partially or completely released PCL. Outcomes were measured with Knee Society scores, complications, revision TKA, and survival. Radiographs were analyzed for component alignment and evidence of loosening. Results: Total 100 TKA were performed in seventy patients comprising of 53 females and 17 males. Mean follow-up in the study was 2.4 years (2-3 years). Knee Society Score for clinical and function scale increased from means of 54.2 (range, 36-68) and 48.6 (range, 33-62) preoperatively to 93.1 (range, 82-100) and 90.4 (range, 76-100) at final follow-up respectively. Results were good or excellent in 93.5 % of knees (79 excellent, 8 good); 6 patients reported fair results. Conclusion: The use of an anterior stabilized (AS) bearing for PCL substitution has comparable clinical and radiographic results to traditional Cruciate Retaining (CR) and Posterior Stabilized (PS) TKA. These results suggest that this approach is an effective method to achieve stability without the PCL in primary TKA with the advantage of bone conservation.
Authors and Affiliations
Dr. Neelam Ramana Reddy, Dr. Abhishek Bhalotia, Dr. Rajesh Podili, Dr. Naveen Malu
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