RETENTION VERSUS SACRIFICE OF THE POSTERIOR CRUCIATE LIGAMENT IN TOTAL KNEE REPLACEMENT
Ahmed Morrah, Hesham Mesbah, Ahmed Ghoneimy, Fekri Aly
Department of Orthopedic Surgery, Cairo University Hospitals, Cairo, Egypt
Objective: in this retrospective study, we aimed to highlight the role of the posterior cruciate ligament (PCL) in total knee replacement (TKR). Is it essential, beneficial or hindrance? Subjects and methods: forty six patients (50 knees, 9 males and 37 females) with degenerative arthritis were treated from March 2008 to June 2011. Of these, 37 knees were primary osteoarthritis, 9 knees were rheumatoid arthritis and 4 knees were posttraumatic osteoarthritis. Age of the patients ranged from 55 to 83 years (mean 66.8 years). The average follow-up period was 23 months (range 10-36). The main outcome measures evaluated were pain, range of motion and stability. Radiographic and clinical evidence of functional outcome and complications were also evaluated. Results: The overall results for PCL-retained group were 84.6% excellent, 11.5% good and 3.9% fair. For PCL-resected group, 79.2% excellent, 16.7% good and 4.1% fair. No significant differences were noted in the overall results between the two groups. The radiographic changes showed no discernable differences. Conclusion: Cruciate-retaining and cruciate-substituting total knee arthroplasties function equally well at 3 years postoperatively. The ultimate differences between the patients who underwent CR- TKR and CS- TKR need to be examined after long-term follow up.
June 2012