A study on functional outcome of posterior cruciate ligament substituted total knee arthroplasty

Authors

  • K. Vijaya Bhaskar Reddy Department of Orthopaedics, MNR Medical College and Hospital, Sangareddy, Telangana, India
  • N. Brahma Chary Department of Orthopaedics, MNR Medical College and Hospital, Sangareddy, Telangana, India
  • Birru Sumanth Department of Orthopaedics, MNR Medical College and Hospital, Sangareddy, Telangana, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20214182

Keywords:

Osteoarthritis, Oxford knee score, Posterior cruciate ligament

Abstract

Background: Total knee replacement surgery is considered as a treatment of choice in patients with advanced arthritis, especially in patients where conservative treatment has been failed. Total knee replacement gives good pain relief, functional improvement of knee and correction of deformity.

Methods: This is study of 39 patients following total knee arthroplasty, who were operated between August 2017 and March 2020 at MNR Medical College and Hospital, Sangareddy. They were followed up for a minimum period of 1 year and evaluated using oxford knee scoring system. Oxford knee score is designed specifically for measuring outcomes in knee arthroplasty. There were 14 right knees, 10 left knees, 15 bilateral knees.

Results: There was a significant functional improvement of knee in patients and we had achieved excellent results, out of 39 patients and 4 patients had post op suprapatellar fullness, which was relieved with medications for 3 weeks and 2 patients (2 knees) without no signs of immediate post-operative period, developed infection after 6 months followed which underwent staged revision total knee replacement. The outcome categories based on oxford knee scoring system: excellent (40-48), good (30-39), fair (20-29) and poor (0-19).

Conclusions: It is difficult to balance the knee with retention of posterior cruciate ligament, whereas posterior cruciate ligament substituting total knee replacement gives reproducible and good results, hence it is the preferred mode of management.

Author Biographies

K. Vijaya Bhaskar Reddy, Department of Orthopaedics, MNR Medical College and Hospital, Sangareddy, Telangana, India

MNR Medical College and Hospital, Sangareddy

N. Brahma Chary, Department of Orthopaedics, MNR Medical College and Hospital, Sangareddy, Telangana, India

Department of Orthopaedics, MNR Medical College and Hospital, Sangareddy.

Birru Sumanth, Department of Orthopaedics, MNR Medical College and Hospital, Sangareddy, Telangana, India

MNR Medical College and Hospital, Sangareddy.

References

Yacovelli S, Grau LC, Hozack WJ, Courtney PM. Functional Outcomes are Comparable Between Posterior Stabilized and Cruciate-Substituting Total Knee Arthroplasty Designs at Short-Term Follow-up. J Arthroplasty. 2021;36(3):986-90.

shii Y, Noguchi H, Sato J, Sakurai T, Toyabe SI. Anteroposterior translation and range of motion after total knee arthroplasty using posterior cruciate ligament-retaining versus posterior cruciate ligament-substituting prostheses. Knee Surg Sports Traumatol Arthrosc. 2017;25(11):3536-42.

Saini C L, Gautam V K, Mehta V M. Comparision of outcomes of posterior cruciate ligament substituting vs retaining in total knee arthroplasty-a prospective, randomised, open labelled study of 30 cases. Indian J Orthop Surg. 2020;6(4):277-82

Miller A, Friedman B. Fascial arthroplasty of the knee. J Bone Joint Surg Am. 1952;34(1):55-63.

Swanik BC. Proprioception, kinesthesia, and balance after total knee arthroplasty with cruciate retaining and posterior stabilized prostheses. J Bone Joint Surg. 2004;86:328-34.

Andriacchi TP, Galante JO, Fermier RW. The influence of total knee Replacement design on walking and stair climbing. J Bone Joint Surg. 1982;64:1328.

Dennis DA, Clayton ML, O'Donnell S. Posterior cruciate condylar total knee arthroplasty: average 11-year followup examination. Clin Orthop Relat Res. 1992;281:168.

Dennis DA, Komistek RD, Stiehl JB. Range of motion after total knee arthroplasty: the effect of implant design and weight-bearing conditions. J Arthroplasty. 1998;13:748.

Maruyama S, Yoshiya S, Matsui N, Kuroda R, Kurosaka M. Functional comparison of posterior cruciate retaining versus posterior stabilized total knee arthroplasty. J Arthroplasty. 2004;19:349-53.

Kim RH, Scott WN. Operative techniques: total knee replacement. Philadelphia: Saunders-Elsevier. 2009;91-103.

Barrack L. Resurfacing of the patella in total knee arthroplasty: a prospective, randomized, double-blind study. J Bone Joint Surg. 1997;79:1121-31.

Myles CM, Rowe PJ, Nutton RW, Burnett R. The effect of patella resurfacing in total knee arthroplasty on functional range of movement measured by flexible electrogoniometry: 2006;21(7):733-9.

Wood. Clinical outcomes and walking analysis after total knee arthroplasty with and without patellar resurfacing: a prospective randomized trial. J Bone Joint Surg. 2005;338-39.

Jacobs WCH, Clement D, Wymenga AB. Retention versus removal of the posterior cruciate ligament in total knee replacement. A systematic literature review within the Cochrane framework. Acta Orthopaedica. 2005;76:757-68.

Downloads

Published

2021-10-26

Issue

Section

Original Research Articles