A Comparative Study of Clinical Outcomes Between Cruciate-Retaining and Posterior-Stabilized Total Knee Arthroplasty: A Propensity Score-Matched Cohort Study

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2023 Oct 24

PMID 37872897

Authors

Keiichiro Yamamoto

Arata Nakajima

Masato Sonobe

Yorikazu Akatsu

Manabu Yamada

Koichi Nakagawa

Affiliations

Soon will be listed here.

Abstract

Introduction: We investigated a comparison of clinical outcomes between cruciate-retaining (CR) and posterior-stabilized (PS) total knee arthroplasty. However, it is still controversial which design leads to better clinical results. In clinical settings, choosing either CR or PS is likely based on the surgeon's preferences. In this study, short-term clinical outcomes between CR and PS in patients who received a single knee prosthesis were compared using propensity score matching.

Methods: Two hundred and twelve CR and 43 PS of a single knee prosthesis were enrolled in this study. After propensity score matching, 34 knees each in the CR and PS groups were chosen and were without significant differences in age at operation, gender, BMI, preoperative range of motion (ROM), preoperative femorotibial angle (FTA), and presence or absence of patellar replacement. Clinical scores, including ROM, Knee Society score (KSS), knee injury and osteoarthritis outcome score (KOOS), except for the sports subscale, were compared between the CR and PS groups preoperatively and two years postoperatively.

Results: Postoperatively, there were no significant differences in FTA, ROM, or KSS. Preoperative scores for the KOOS except for the pain subscale were comparable between the groups. Postoperatively, however, the PS group had a significantly higher score in the ADL subscale compared to the CR group (PS: 89.5 vs. CR: 80.8, p = 0.017). The KOOS subscales other than activities of daily living (ADL) were comparable between the groups.

Conclusions: In this propensity score-matched cohort study, PS showed a better outcome for the ADL than the CR design. These findings suggest that choosing either CR or PS should not depend on the surgeon's preferences. A PS design may be preferable to CR for elderly patients.

Citing Articles

Comparison of Clinical and Patient Reported Outcomes in One-Sided Cruciate-Retaining Versus Other-Sided Posterior Stabilizing Protheses in Bilateral Simultaneous Total Knee Arthroplasty.

Vishnu R, Datta B, Prasad R, Vishnuprasad R Indian J Orthop. 2024; 59(1):47-53.

PMID: 39735870 PMC: 11680534. DOI: 10.1007/s43465-024-01277-2.

Metal-backed or all-poly tibial components: which are better for medial unicompartmental knee arthroplasty? A propensity-score-matching retrospective study at the 5-year follow-up.

Piovan G, De Berardinis L, Screpis D, Senarighi M, Povegliano L, Natali S J Orthop Traumatol. 2024; 25(1):24.

PMID: 38704499 PMC: 11069491. DOI: 10.1186/s10195-024-00765-3.

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