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Cruciate-substituting TKA demonstrates superior clinical outcomes to cruciate-retaining TKA
Although both cruciate-retaining and cruciate-substituting total knee arthroplasty demonstrated excellent survivorship, the cruciate-substituting design demonstrated superior clinical outcomes, according to study results.
Researchers assessed 414 knees of 360 patients who underwent total knee arthroplasty (TKA) and were implanted with a Genesis II (Smith & Nephew) knee between January 1995 and January 2000. Overall, 143 TKAs included a posterior cruciate-retaining (CR) implant and 271 TKAs included a posterior cruciate-substituting (CS) implant. Average postoperative follow-up was 12.3 years.
Results showed two knees required revision surgery in the CR group and nine knees required revision surgery in the CS group. At 10-year survivorship, the researchers found excellent survivorship in both cohorts with no significant between-group differences, even when accounting for infections.
At a minimum of 10 years, clinical scores favored the CS group in terms of Knee Society Rating Scores, WOMAC scores and SF-12 scores, according to the researchers. The CS group also had a trend toward slightly greater knee flexion.
The researchers found the CS group demonstrated significantly better changes in scores for Knee Society Clinical Rating, WOMAC, SF-12 physical component scores, as well as improved knee range of motion. – by Casey Tingle
Disclosures: McCalden is a paid consultant for Smith & Nephew; received institutional research support from Smith & Nephew, DePuy and Stryker; and is a reviewer for The Journal of Arthroplasty and Clinical Orthopaedics and Related Research. Please see the full study for a list of all other authors’ relevant financial disclosures.