Abstract
Introduction
The purpose of this study was to determine whether the patient's perceived outcome and speed of recovery differs between a posterior cruciate ligament (PCL) substituting (cam-post type) and PCL sacrificing (ultracongruent polyethylene) total knee arthroplasty (TKA).
Methods
Thirty eight patients (mean age, 65 years) underwent bilateral TKA using a PCL substituting and a PCL sacrificing prosthesis on each side. At each follow-up, the stability of anteroposterior and mediolateral laxity using stress radiographs, range of motion, quadriceps muscle power recovery using isokinetic dynamometer and radiographs were evaluated. At the 1-year evaluation, we asked, “Which is your better knee overall?” to determine the patients' preferences.
Results
The mean varus/valgus laxities were 1.6Ë�/3.9Ë� in the PCL sacrificing side and 2.3Ë�/5.9Ë� in the PCL substituting side, and the mean anterior/posterior laxities were 6.4 mm/14.2 mm and 3.0 mm/7.3 mm at the 1-year follow up, respectively. Isokinetic peak torque at 60°/sec and 180°/sec in extension was 130% and 113% compared to the preoperative value in the PCL sacrificing side and 109% and 110% in the PCL substituting side, respectively. The differences in the posterior laxity and isokinetic peak torque at 60°/sec were significant statistically. Sixty-one percent preferred PCL sacrificing side to PCL substituting side.
Conclusion
PCL sacrificing TKA showed more posterior laxity and better quadriceps muscle power at the time of short-term follow-up. Patients with bilateral TKA preferred PCL sacrificing TKA to PCL substituting TKA. Longer follow-up is needed to determine whether there will be an advantage in terms of longer-term function.
