12-Year clinical and radiological results of a double-blind randomized controlled trial comparing posterior cruciate-retaining versus posterior-stabilized total knee arthroplasty

• Published in: The knee Vol. 45; pp. 110 - 116
• Main Authors: Kersten, R F M R, de Vries, A J, van Raaij, J J A M, Brouwer, R W
• Format: Journal Article
• Language: English
• Published: Netherlands 01.12.2023
• Subjects: Arthroplasty, Replacement, Knee - methods; Humans; Knee Joint - diagnostic imaging; Knee Joint - surgery; Knee Prosthesis; Osteoarthritis, Knee - diagnostic imaging; Osteoarthritis, Knee - surgery; Posterior Cruciate Ligament - diagnostic imaging; Posterior Cruciate Ligament - surgery; Prostheses and Implants; Prosthesis Design; Range of Motion, Articular; Patient reported outcome measures; Long-term survival; Posterior cruciate retaining; Total knee arthroplasty; Randomized controlled trial; Posterior stabilizing
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2023.10.006

A subject of ongoing debate among orthopedic surgeons is the importance of preserving the posterior cruciate ligament in total knee arthroplasty (TKA), but long-term survival studies are scarce. The aim of this study was to compare long-term survival rates, and clinical and radiological follow up of a double-blind randomized controlled trial comparing posterior cruciate-retaining (PCR) versus posterior-stabilizing (PS) implant design of an AGC TKA. A total of 114 patients were included in the survival analysis (PCR n = 61; PS n = 53). Forty-five patients (PCR n = 25; PS n = 20) participated in the long-term follow up using patient-reported outcome measures (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short-Form Health Survey (SF-36) and Kujala score (measuring anterior knee pain)). Thirty-one patients were assessed with a physical test (Knee Society Score (KSS)) and radiographs. Overall survival rate was 95.6% (PCR 98.4% vs. PS 92.5%), with five patients having a major revision (PCR n = 1 vs. PS n = 4, respectively). Satisfying outcome scores for both groups were described at on average 12-year follow up with no significant differences in KSS knee and function scores, WOMAC, SF-36, or Kujala scores between groups. Radiographically, there were no findings of femoral or tibial loosening or polyethylene wear in either group. Good long-term survival rates were described for the PCR and the PS design of an AGC TKA. There were no significant differences in clinical and radiological outcomes between a PCR and a PS design 12 years postoperatively.