THE POSTERIOR STABILISED KNEE: NO POST REQUIRED – OPPOSES

J.J. Callaghan

doi:10.1302/1358-992X.96BSUPP_12.CCJR2014-059

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General Orthopaedics

THE POSTERIOR STABILISED KNEE: NO POST REQUIRED – OPPOSES

Current Concepts in Joint Replacement (CCJR) – Spring 2014

J.J. Callaghan

THE POSTERIOR STABILISED KNEE: NO POST REQUIRED – OPPOSES

Callaghan J. THE POSTERIOR STABILISED KNEE: NO POST REQUIRED – OPPOSES. Orthop Procs. 2014;96-B(SUPP_12):59-59. doi:10.1302/1358-992X.96BSUPP_12.CCJR2014-059

Callaghan, J.J.. “THE POSTERIOR STABILISED KNEE: NO POST REQUIRED – OPPOSES.” Orthopaedic Proceedings, vol. 96-B, no. SUPP_12, 2014, pp. 59-59., https://doi.org/10.1302/1358-992X.96BSUPP_12.CCJR2014-059

Callaghan, J. (2014). THE POSTERIOR STABILISED KNEE: NO POST REQUIRED – OPPOSES. Orthopaedic Proceedings, 96-B(SUPP_12), 59-59. https://doi.org/10.1302/1358-992X.96BSUPP_12.CCJR2014-059

Callaghan, J. (2014) “THE POSTERIOR STABILISED KNEE: NO POST REQUIRED – OPPOSES.” Orthopaedic Proceedings, 96-B(SUPP_12), pp. 59-59. Available at: https://doi.org/10.1302/1358-992X.96BSUPP_12.CCJR2014-059

Callaghan, J.J. “THE POSTERIOR STABILISED KNEE: NO POST REQUIRED – OPPOSES.” Orthopaedic Proceedings 96-B, no. SUPP_12 (2014): 59-59. https://doi.org/10.1302/1358-992X.96BSUPP_12.CCJR2014-059

Callaghan J. THE POSTERIOR STABILISED KNEE: NO POST REQUIRED – OPPOSES. Orthop Procs. 2014 Jul 1;96-B(SUPP_12):59-59. https://doi.org/10.1302/1358-992X.96BSUPP_12.CCJR2014-059

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Abstract

Whether to preserve the posterior cruciate ligament in total knee arthroplasty remains a topic of debate. Long term studies out to 20 or more years have shown both posterior-stabilised (PS) as well as cruciate-retaining (CR) total knees to perform well. Studies supporting both sides are abundant, and there are even studies supporting one being superior to the other, and vice versa.

In closer examination of this issue through a recent meta-analysis, the following conclusions can be drawn:

Flexion: mean difference of 2.24, favoring PS designs (p = 0.009)
Range of Motion: mean difference of 3.33, favoring PS designs (p = 0.0009)
Complications: no statistical difference between PS vs CR
Proprioception
Swanik et al. – PS knee patients were more accurate at reproducing joint position
My bias: PS knees can be utilised in all patients with all deformities

Patellar crepitance with PS designs can be minimised with design alternations and techniques for patella preparation

Any issues with post impingement can be minimised using PS rotating platform designs

The debate of PS vs CR total knees remains unresolved. There is not a 100% clear advantage. Surgeons should make their choice based on their own clinical outcomes, objectively monitored over the long term. For me personally, the choice is PS.