Joint line descends and patellar height ascends in posterior cruciate retaining or sacrificing total knee arthroplasty with the same clinical outcomes
ESSKA Academy. Pedemonte Parram G. 11/08/19; 285246; epEKA-25 Topic: Joint Replacement
Gloria Pedemonte Parram
Gloria Pedemonte Parram
Login now to access Regular content available to all registered users.

You can access free regular educational content on the ESSKA Academy by registering as an 'ESSKA Academy User’ here

Access to Premium content is currently a membership benefit.

Click here to join ESSKA or renew your membership.
Abstract
Discussion Forum (0)
Rate & Comment (0)
Introduction and objective: It is essential to reproduce the joint line (JL) in order to obtain a normal total knee arthroplasty (TKA) kinematics. Diversity in Knee bone geometry, laxity and alignment may hinder JL and patellar height (PH) restoration. The design of the prosthesis and the preservation or not of the posterior cruciate ligament (PCL) influences joint kinematics, but it is not known if it would modify the position of the JL and PH.
The objective of the study was to analyze if JL, PH and clinical outcome is modified depending on the implantation of a cruciate retaining (CR) or sacrificing (PS) TKA or on the trademark of the TKA.
Material and methods: A retrospective cohorts study of 96 TKA was carried out from June 2015 to June 2016. Sixty Genutech™ TKA, 30 CR and 30 PS, (group A); and 36 NexGen ™ TKA, 6 CR and 30 PS, (group B) were compared in each group and between groups. The same surgical technique and rehabilitation protocol was performed in all cases.
At one-year follow up all patients were examined clinically using the Knee Society Score (KSS) and McMaster Universities Osteoarthritis Index (WOMAC). All patients underwent pre and postoperative antero-posterior weight bearing, lateral and 30º axial radiographs. The JL was measured as the distance from the lateral femoral condyles to the fibular head, and PH was established as the ratio between the distance from the inferior patellar pole to the joint line and the patellar length (RDPC). Twice the same observer took radiographic measures (RAIM Viewer® version 2.5.0.511).
The data in the same group were analyzed using T-Test and between the two groups using ANOVA test for equality of variances. All analyzes were carried out using the SPSSv.21 and the p-value was established at < 0.05.
Results: Postoperatively, the JL height was decreased (p< 0.0001) whereas PH was increased (p=0.008) in CR and PS TKA, in groups A and B. No pre/postoperative differences were found between groups A and B, in PS or CR TKA.
No differences were found in one year KSS and WOMAC scores in CR and PS TKA in each group and between groups.
Conclusion: After a CR or PS TKA the JL height descends and the PH ascends independently of the trademark of the TKA. No clinical differences at one-year follow up were found in CR and PS TKA independently of the trademark.
Although, these radiological results have not shown clinical differences in short term follow up, we do not know if they could have a long-term effect.
Introduction and objective: It is essential to reproduce the joint line (JL) in order to obtain a normal total knee arthroplasty (TKA) kinematics. Diversity in Knee bone geometry, laxity and alignment may hinder JL and patellar height (PH) restoration. The design of the prosthesis and the preservation or not of the posterior cruciate ligament (PCL) influences joint kinematics, but it is not known if it would modify the position of the JL and PH.
The objective of the study was to analyze if JL, PH and clinical outcome is modified depending on the implantation of a cruciate retaining (CR) or sacrificing (PS) TKA or on the trademark of the TKA.
Material and methods: A retrospective cohorts study of 96 TKA was carried out from June 2015 to June 2016. Sixty Genutech™ TKA, 30 CR and 30 PS, (group A); and 36 NexGen ™ TKA, 6 CR and 30 PS, (group B) were compared in each group and between groups. The same surgical technique and rehabilitation protocol was performed in all cases.
At one-year follow up all patients were examined clinically using the Knee Society Score (KSS) and McMaster Universities Osteoarthritis Index (WOMAC). All patients underwent pre and postoperative antero-posterior weight bearing, lateral and 30º axial radiographs. The JL was measured as the distance from the lateral femoral condyles to the fibular head, and PH was established as the ratio between the distance from the inferior patellar pole to the joint line and the patellar length (RDPC). Twice the same observer took radiographic measures (RAIM Viewer® version 2.5.0.511).
The data in the same group were analyzed using T-Test and between the two groups using ANOVA test for equality of variances. All analyzes were carried out using the SPSSv.21 and the p-value was established at < 0.05.
Results: Postoperatively, the JL height was decreased (p< 0.0001) whereas PH was increased (p=0.008) in CR and PS TKA, in groups A and B. No pre/postoperative differences were found between groups A and B, in PS or CR TKA.
No differences were found in one year KSS and WOMAC scores in CR and PS TKA in each group and between groups.
Conclusion: After a CR or PS TKA the JL height descends and the PH ascends independently of the trademark of the TKA. No clinical differences at one-year follow up were found in CR and PS TKA independently of the trademark.
Although, these radiological results have not shown clinical differences in short term follow up, we do not know if they could have a long-term effect.
Code of conduct/disclaimer available in General Terms & Conditions

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies