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Comparison of outcomes after bilateral simultaneous total knee arthroplasty using posterior-substituting versus cruciate-retaining prostheses.

Liu HG, Zhu W, Zhang ZX - Saudi Med J (2015)

Bottom Line: To compare the effectiveness and safety of posterior-substituting (PS) with cruciate-retaining (CR) total knee prostheses after the elimination of confounding variables.However, the PS total knee design did display statistically significant improvements in range of motion as compared with the CR design.While comparable regarding supporting good clinical outcomes, the PS design does appear to support significantly improved postoperative range of motion when compared with the CR design.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou, Jiangsu, People's Republic of China. E-mail. zzm20101113@gmail.com.

ABSTRACT

Objectives: To compare the effectiveness and safety of posterior-substituting (PS) with cruciate-retaining (CR) total knee prostheses after the elimination of confounding variables.

Methods: Between January 2008 and June 2012, a total of 32 subjects who had bilateral arthritis of the knees agreed to have one knee replaced with a PS total knee design and the other with a CR design. In addition to postoperative complications, clinical outcomes (Knee Society Score, Range of Motion, Western Ontario and McMaster Universities Arthritis Index, as well as radiographic findings) were evaluated preoperatively, and at 2-week, 3-month, 12-month, and 24-month follow-up.

Results: At the 24-month follow-up interval, no benefit of CR design was observed over PS design regarding functional assessment, patient satisfaction, or postoperative complication. However, the PS total knee design did display statistically significant improvements in range of motion as compared with the CR design.

Conclusion: While comparable regarding supporting good clinical outcomes, the PS design does appear to support significantly improved postoperative range of motion when compared with the CR design.

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Related in: MedlinePlus

Preoperative and postoperative assessment at each follow-up. Comparison of group mean values using the paired t-test or Wilcoxon signed ranked test. The threshold for statistical significance was set at a p-value of less than 0.05. CR - cruciate-retaining, PS - posterior-substituting, Pre-op - preoperative, ROM - range of motion, WOMAC - Western Ontario and MacMaster Universities Osteoarthritis Index.
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Figure 1: Preoperative and postoperative assessment at each follow-up. Comparison of group mean values using the paired t-test or Wilcoxon signed ranked test. The threshold for statistical significance was set at a p-value of less than 0.05. CR - cruciate-retaining, PS - posterior-substituting, Pre-op - preoperative, ROM - range of motion, WOMAC - Western Ontario and MacMaster Universities Osteoarthritis Index.

Mentions: Preoperative and postoperative clinical assessments are displayed in Figure 1. At 24-month follow-up, the KSS averaged 89.5 points for CR knees and 90.1 points for PS knees, indicating an overall comparable recovery for both types of knees. No statistical significance was detected in terms of 24-month postoperative pain ratings between the CR and PS knees. Regarding ROM, a statistically significant difference was measured between mean flexion of the CR and PS knees at the 24-month follow-up. The preoperative mean function scores were 45.2 points for the CR knees and 43.7 points for the PS knees. At the 24-month follow-up, the score was 65.6 for the CR knees and 67.0 for the PS knees. The obtained results indicated that compared with the CR group, the PS group showed a trend toward higher functional scores. This difference was not notable. Although it appeared that the 24-month postoperative WOMAC assessment of the PS knees was superior to the CR knees, the difference was not significant.


Comparison of outcomes after bilateral simultaneous total knee arthroplasty using posterior-substituting versus cruciate-retaining prostheses.

Liu HG, Zhu W, Zhang ZX - Saudi Med J (2015)

Preoperative and postoperative assessment at each follow-up. Comparison of group mean values using the paired t-test or Wilcoxon signed ranked test. The threshold for statistical significance was set at a p-value of less than 0.05. CR - cruciate-retaining, PS - posterior-substituting, Pre-op - preoperative, ROM - range of motion, WOMAC - Western Ontario and MacMaster Universities Osteoarthritis Index.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4375696&req=5

Figure 1: Preoperative and postoperative assessment at each follow-up. Comparison of group mean values using the paired t-test or Wilcoxon signed ranked test. The threshold for statistical significance was set at a p-value of less than 0.05. CR - cruciate-retaining, PS - posterior-substituting, Pre-op - preoperative, ROM - range of motion, WOMAC - Western Ontario and MacMaster Universities Osteoarthritis Index.
Mentions: Preoperative and postoperative clinical assessments are displayed in Figure 1. At 24-month follow-up, the KSS averaged 89.5 points for CR knees and 90.1 points for PS knees, indicating an overall comparable recovery for both types of knees. No statistical significance was detected in terms of 24-month postoperative pain ratings between the CR and PS knees. Regarding ROM, a statistically significant difference was measured between mean flexion of the CR and PS knees at the 24-month follow-up. The preoperative mean function scores were 45.2 points for the CR knees and 43.7 points for the PS knees. At the 24-month follow-up, the score was 65.6 for the CR knees and 67.0 for the PS knees. The obtained results indicated that compared with the CR group, the PS group showed a trend toward higher functional scores. This difference was not notable. Although it appeared that the 24-month postoperative WOMAC assessment of the PS knees was superior to the CR knees, the difference was not significant.

Bottom Line: To compare the effectiveness and safety of posterior-substituting (PS) with cruciate-retaining (CR) total knee prostheses after the elimination of confounding variables.However, the PS total knee design did display statistically significant improvements in range of motion as compared with the CR design.While comparable regarding supporting good clinical outcomes, the PS design does appear to support significantly improved postoperative range of motion when compared with the CR design.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou, Jiangsu, People's Republic of China. E-mail. zzm20101113@gmail.com.

ABSTRACT

Objectives: To compare the effectiveness and safety of posterior-substituting (PS) with cruciate-retaining (CR) total knee prostheses after the elimination of confounding variables.

Methods: Between January 2008 and June 2012, a total of 32 subjects who had bilateral arthritis of the knees agreed to have one knee replaced with a PS total knee design and the other with a CR design. In addition to postoperative complications, clinical outcomes (Knee Society Score, Range of Motion, Western Ontario and McMaster Universities Arthritis Index, as well as radiographic findings) were evaluated preoperatively, and at 2-week, 3-month, 12-month, and 24-month follow-up.

Results: At the 24-month follow-up interval, no benefit of CR design was observed over PS design regarding functional assessment, patient satisfaction, or postoperative complication. However, the PS total knee design did display statistically significant improvements in range of motion as compared with the CR design.

Conclusion: While comparable regarding supporting good clinical outcomes, the PS design does appear to support significantly improved postoperative range of motion when compared with the CR design.

Show MeSH
Related in: MedlinePlus