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FLEXION INSTABILITY IN TOTAL KNEE REPLACEMENT, A COMPARISON OF POSTERIOR STABILISED AND DEEP DISHED COMPONENTS



Abstract

Introduction The aim of this study was to examine the flexion stability of posterior stabilised (PS) compared with deep dished (DD) tibial inserts in PCL sacrificing total knee arthroplasty using posterior stress radiography.

Methods Kneeling posterior stress radiographs at 90° of flexion were taken pre and post-operatively in 36 knees undergoing primary arthroplasty with PCL resection (26 DD and 10 PS implants). Sagittal plane tibial translation was measured.

Results The deep dish inserts all showed posterior displacement (mean: −5.1 mm, range: −2 to −12 mm). The posterior stabilised implants were all displaced anteriorly (mean: +6.7 mm, range: +3 to +12 mm). The difference in translation was highly significant (P< 0.0001). There was a strong correlation between implant and position of the tibia (R = 0.86). In seven patients comparison was possible between a DD component in one knee and a PS implant in the other. There was a mean post-operative side to side difference of 11 mm (range: 5 to 21 mm).

Conclusions This study discriminates between two implant types on stress x-rays. The posterior tibial displacement in the DD group suggests that this implant does not provide enough posterior flexion stability to compensate for the PCL resection. The anterior translation in the PS group has implications for the design and wear of the post as well as advice to patients about possibly avoiding kneeling in this PS design.

The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.

None of the authors have received any payment or consideration from any source for the conduct of this study.