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Patient preferences in knee prostheses.

J W Pritchett1

  • 1Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington, USA.

The Journal of Bone and Joint Surgery. British Volume
|September 28, 2004
PubMed
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Patients undergoing bilateral total knee replacement (TKR) showed no significant differences in outcomes across four prosthesis types. However, cruciate-retaining and medial/lateral pivot designs were frequently preferred over posterior cruciate-substituting options.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Total knee replacement (TKR) is a common procedure for end-stage knee arthritis.
  • Various prosthetic designs aim to optimize function and patient satisfaction.
  • Understanding patient preferences among different TKR designs is crucial for surgical decision-making.

Purpose of the Study:

  • To compare the clinical outcomes and patient preferences for four different total knee replacement prostheses.
  • To evaluate the functional performance of cruciate-retaining and cruciate-substituting knee implants.

Main Methods:

  • A cohort of 344 patients received bilateral TKRs with different prostheses implanted on each side.
  • Four types of prostheses were used: anterior and posterior cruciate-retaining (ACL-PCL), posterior cruciate-retaining (PCL), medial or lateral pivot (MLP), and posterior cruciate-substituting (PS).

Related Experiment Videos

  • Patient-reported outcomes including range of motion, pain relief, alignment, stability, and subjective preference were assessed.

    • Main Results:

    • All patients reported good or excellent outcomes, with no significant variations in range of motion, pain relief, alignment, or stability among the four prosthesis types.
    • A significant majority of patients preferred the ACL-PCL (89%) and MLP (77%) prostheses over the PS prosthesis.
    • The MLP prosthesis was also preferred over the PCL prosthesis by 79% of patients.

    Conclusions:

    • While objective functional outcomes were similar across all tested TKR prostheses, patient preferences leaned towards designs that retain or mimic cruciate ligament function.
    • The ACL-PCL and MLP designs appear to offer superior subjective patient satisfaction compared to the PS design.
    • These findings suggest that patient preference for cruciate-retaining or medial/lateral pivot designs should be considered in TKR selection.