Cargando…

The role of the posterior cruciate ligament in total knee replacement

OBJECTIVES: The purpose of this study was to examine the effect of posterior cruciate ligament (PCL) retention, PCL recession, and PCL excision during cruciate-retaining total knee replacement. METHODS: A total of 3018 anatomic graduated component total knee replacements were examined; 1846 of these...

Descripción completa

Detalles Bibliográficos
Autores principales: Ritter, M. A., Davis, K. E., Meding, J. B., Farris, A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Editorial Society of Bone and Joint Surgery 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3626208/
https://www.ncbi.nlm.nih.gov/pubmed/23610673
http://dx.doi.org/10.1302/2046-3758.14.2000024
_version_ 1782266165365571584
author Ritter, M. A.
Davis, K. E.
Meding, J. B.
Farris, A.
author_facet Ritter, M. A.
Davis, K. E.
Meding, J. B.
Farris, A.
author_sort Ritter, M. A.
collection PubMed
description OBJECTIVES: The purpose of this study was to examine the effect of posterior cruciate ligament (PCL) retention, PCL recession, and PCL excision during cruciate-retaining total knee replacement. METHODS: A total of 3018 anatomic graduated component total knee replacements were examined; 1846 of these retained the PCL, 455 PCLs were partially recessed, and in 717 the PCL was completely excised from the back of the tibia. RESULTS: Clinical scores between PCL groups favored excision for flexion (p < 0.0001), and recession and retention for stairs (p < 0.0001). There was a mild difference in long-term all-cause aseptic survivorship between PCL-retained (96.4% at 15 years) combined with PCL-recessed groups (96.6% at 15 years) when compared with the PCL-excised group (95.0% at 15 years) (p = 0.0411, Wilcoxon; p = 0.0042, log-rank), as well as tibial or femoral loosening, which reported prosthesis survival of 97.8% at 15 years for PCL-retained knees, 98.2% for recessed knees, and 96.4% for excised knees (p = 0.0934, Wilcoxon; p = 0.0202, log-rank). CONCLUSIONS: Despite some trade off in clinical performance, if the PCL is detached at the time of operation, conversion to a posterior-stabilised prosthesis may not be necessarily required as long as stability in the anteroposterior and coronal planes is achieved.
format Online
Article
Text
id pubmed-3626208
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher British Editorial Society of Bone and Joint Surgery
record_format MEDLINE/PubMed
spelling pubmed-36262082013-04-22 The role of the posterior cruciate ligament in total knee replacement Ritter, M. A. Davis, K. E. Meding, J. B. Farris, A. Bone Joint Res Knee OBJECTIVES: The purpose of this study was to examine the effect of posterior cruciate ligament (PCL) retention, PCL recession, and PCL excision during cruciate-retaining total knee replacement. METHODS: A total of 3018 anatomic graduated component total knee replacements were examined; 1846 of these retained the PCL, 455 PCLs were partially recessed, and in 717 the PCL was completely excised from the back of the tibia. RESULTS: Clinical scores between PCL groups favored excision for flexion (p < 0.0001), and recession and retention for stairs (p < 0.0001). There was a mild difference in long-term all-cause aseptic survivorship between PCL-retained (96.4% at 15 years) combined with PCL-recessed groups (96.6% at 15 years) when compared with the PCL-excised group (95.0% at 15 years) (p = 0.0411, Wilcoxon; p = 0.0042, log-rank), as well as tibial or femoral loosening, which reported prosthesis survival of 97.8% at 15 years for PCL-retained knees, 98.2% for recessed knees, and 96.4% for excised knees (p = 0.0934, Wilcoxon; p = 0.0202, log-rank). CONCLUSIONS: Despite some trade off in clinical performance, if the PCL is detached at the time of operation, conversion to a posterior-stabilised prosthesis may not be necessarily required as long as stability in the anteroposterior and coronal planes is achieved. British Editorial Society of Bone and Joint Surgery 2012-04-01 /pmc/articles/PMC3626208/ /pubmed/23610673 http://dx.doi.org/10.1302/2046-3758.14.2000024 Text en ©2012 British Editorial Society of Bone and Joint Surgery This is an open-access article distributed under the terms of the Creative Commons Attributions licence, which permits unrestricted use, distribution, and reproduction in any medium, but not for commercial gain, provided the original author and source are credited.
spellingShingle Knee
Ritter, M. A.
Davis, K. E.
Meding, J. B.
Farris, A.
The role of the posterior cruciate ligament in total knee replacement
title The role of the posterior cruciate ligament in total knee replacement
title_full The role of the posterior cruciate ligament in total knee replacement
title_fullStr The role of the posterior cruciate ligament in total knee replacement
title_full_unstemmed The role of the posterior cruciate ligament in total knee replacement
title_short The role of the posterior cruciate ligament in total knee replacement
title_sort role of the posterior cruciate ligament in total knee replacement
topic Knee
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3626208/
https://www.ncbi.nlm.nih.gov/pubmed/23610673
http://dx.doi.org/10.1302/2046-3758.14.2000024
work_keys_str_mv AT ritterma theroleoftheposteriorcruciateligamentintotalkneereplacement
AT daviske theroleoftheposteriorcruciateligamentintotalkneereplacement
AT medingjb theroleoftheposteriorcruciateligamentintotalkneereplacement
AT farrisa theroleoftheposteriorcruciateligamentintotalkneereplacement
AT ritterma roleoftheposteriorcruciateligamentintotalkneereplacement
AT daviske roleoftheposteriorcruciateligamentintotalkneereplacement
AT medingjb roleoftheposteriorcruciateligamentintotalkneereplacement
AT farrisa roleoftheposteriorcruciateligamentintotalkneereplacement