Cruciate retaining and posterior stabilized total knee arthroplasty in severe varus osteoarthritis knee: A match-pair comparative study in an Asian population

• Published in: Journal of orthopaedic surgery (Hong Kong) Vol. 29; no. 3; p. 23094990211055224
• Main Authors: Soong, Junwei, Ou Yang, Youheng, Ling, Zhixing Marcus, Chia, Shi-Lu, Lo, Ngai Nung, Yeo, Seng Jin
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.09.2021; Sage Publications Ltd; SAGE Publishing
• Subjects: Arthroplasty, Replacement, Knee; Humans; Joint replacement surgery; Joint surgery; Knee; Knee Joint - surgery; Knee Prosthesis; Osteoarthritis - surgery; Osteoarthritis, Knee - surgery; Posterior Cruciate Ligament - surgery; Range of Motion, Articular; knee; general; Joint replacements; statistics
• ISSN: 2309-4990; 1022-5536; 2309-4990
• DOI: 10.1177/23094990211055224

Background Posterior stabilized (PS) total knee arthroplasty (TKA) is advocated in severe varus osteoarthritic (OA) knees as the posterior cruciate ligament posed challenges in gap balancing. However, there is scarcity in the literature to illustrate the superiority of PS TKA over cruciate retaining (CR) TKA. Our study aims to compare the outcomes between CR and PS TKAs in patients with severe varus OA knees. Methods: A retrospective review was conducted on patients who underwent primary TKA for OA knee from 2003 to 2013. Patients with OA knees of varus tibiofemoral angle ≥15 were matched into two groups (Group CR and PS) according to age, gender, and body mass index and compared in terms of clinical (tibiofemoral alignment, range of motion, and revision rate) and functional outcome (Knee Society Scoring, Oxford Knee Score, Short Form-36 Health Survey). Results: Both Group CR (n = 56) and PS (n = 56) had similar pre-operative scores. Both groups achieved correction of tibiofemoral alignment from median pre-operative varus of 17.6/17.0 (CR/PS) (p = .279) to median post-operative valgus of 4.9/4.0 (CR/PS) (p = .408). Over 24 months, both groups were comparable in achieving significant improvement in clinical and functional outcomes. No case of revision surgery was reported (median follow-up months; CR: 65, PS: 74, p = .549). Conclusion: Both CR and PS TKAs perform similarly well in severe varus OA knee up to 2 years post-operation. Further studies are warranted to assess the long-term outcome between the two implant designs.