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Changes in anteroposterior stability following total knee arthroplasty
Ryotaro Nabeyama1, Shuichi Matsuda, Hiromasa Miura
1Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku,Fukuoka 812-8582, Japan.
Summary
Posterior cruciate ligament (PCL)-retaining total knee arthroplasty (TKA) maintained knee stability, similar to normal knees. PCL-substituting TKA, however, resulted in increased anteroposterior instability compared to normal knees.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Biomedical Engineering
Background:
- Total knee arthroplasty (TKA) aims to restore knee function and stability.
- The role of the posterior cruciate ligament (PCL) in TKA outcomes is debated.
- Understanding anteroposterior (AP) stability is crucial for TKA success.
Purpose of the Study:
- To compare AP stability in flexion and extension after PCL-retaining TKA versus PCL-substituting TKA.
- To evaluate TKA-induced changes in AP stability against normal knee biomechanics.
- To assess long-term AP stability changes at an average of 3 years post-surgery.
Main Methods:
- Prospective evaluation of 29 knees (24 patients) undergoing TKA.
- Group division into PCL-retaining (n=19) and PCL-substituting (n=10) TKA.
- Measurement of AP displacement using a KT-2000 arthrometer preoperatively, 1 month, and 3 years post-surgery.
Main Results:
- PCL-retaining TKA showed no significant change in AP stability compared to normal knees.
- PCL-substituting TKA led to increased AP stability, significantly greater than normal knees at 3 years.
- No significant difference in AP stability was observed between PCL-retaining TKA and normal knees.
Conclusions:
- PCL-retaining TKA preserves native knee AP stability.
- PCL-substituting TKA may result in supra-physiologic AP laxity long-term.
- Surgical technique choice impacts postoperative knee anteroposterior stability.