Comparing Patient Preference for Highly-Congruent versus Cruciate-Retaining Inserts in Bilateral Knee Arthroplasties

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Knee Arthroplasty Research

Background:

• Total knee arthroplasty (TKA) involves implanting artificial joint components.
• Different bearing designs, such as cruciate-retaining (CR) and highly congruent (HC), aim to optimize TKA function.
• Patient preference and long-term outcomes between TKA bearing types are critical for surgical decision-making.

Purpose of the Study:

• To compare patient preference between cruciate-retaining (CR) and highly congruent (HC) bearings in bilateral total knee arthroplasty (TKA).
• To evaluate implant survival, reoperation rates, and range of motion (ROM) for CR versus HC bearings.
• To analyze patient satisfaction and patient-reported outcome measures (PROMs) associated with each bearing type.

Main Methods:

• Retrospective analysis of 104 patients with bilateral TKAs, each receiving one CR and one HC bearing.
• Assessment of implant survival, reoperation rates, ROM, patient preference, satisfaction, and PROMs.
• Univariate analyses were performed to compare outcomes between the two bearing groups.

Main Results:

• No significant patient preference was found between CR and HC bearings (50% had no preference).
• Implant survival and reoperation rates were comparable between the CR and HC groups.
• No differences were observed in overall patient satisfaction, knee flexion, or PROMs between the two bearing types.

Conclusions:

• Patients with bilateral TKAs did not demonstrate a preference for either cruciate-retaining (CR) or highly congruent (HC) bearings.
• Both CR and HC bearings exhibit similar long-term prosthesis survival and functional outcomes in TKA.
• The study supports both CR and HC bearings as reliable and adequate options for total knee arthroplasty.