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Published on: March 26, 2015
Three different cruciate-sacrificing TKA designs: minor intraoperative kinematic differences and negligible clinical
Simone Bignozzi1, Stefano Zaffagnini, Ibrahim Akkawi
1Laboratorio di Biomeccanica e Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy, s.bignozzi@biomec.ior.it.
Purpose:
The goal of this study was to compare three types of mobile-bearing posterior cruciate ligament (PCL)-sacrificing TKA. The hypothesis was that the three designs provide differences in flexion stability and femoral rollback and improved clinical score at 2-year follow-up.
Methods:
Three groups of patients, divided according to implant design, were analysed retrospectively. All operations were guided by a non-image-based navigation system that recorded relative femoral and tibial positions in native and implanted knees during: passive range of motion and anterior drawer test at 90° flexion. WOMAC, KSS and SF36 scores were collected pre-operatively and at 2-year follow-up.
Results:
There are no differences in kinematic or clinical performance of the three implants, except for the antero-posterior translation during stress test in flexion: only Cohort B had comparable pre- and post-operative laxity test values (p < 0.001). All three TKA designs allowed to maintain pre-operative tibial rotation pattern through all range of knee flexion. All clinical scores of the three patient cohorts were significantly improved post-operatively compared to the pre-operative values (p < 0.001). Moreover, we found no differences among post-operative results of the three designs.
Conclusion:
Despite design variations, mobile-bearing PCL-sacrificing TKA reproduces femoral rollback and screw-home with little or no difference in clinical or functional scores at a follow-up of 2 years.
Level Of Evidence:
III.
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