Posterior cruciate-retaining versus posterior-stabilized total knee arthroplasty for osteoarthritis with severe varus deformity

Abstract

Objective: The aim of this study was to compare the radiological and functional results of posterior cruciate ligament (PCL) – retaining and posterior-stabilized total knee arthroplasties in patients with severe varus gonarthrosis. Methods: Medical records of 112 knees of 96 patients who underwent total knee arthroplasty for severe varus (≥15°) were reviewed. PCL-retaining and PCL-stabilizing groups consisted of 58 and 54 knees, respectively. Mean follow-up time was 56.6 months (range: 24–112 months). Knee Society (KS) clinical rating system was used in clinical evaluation. Range of motion, degree of flexion contracture, postoperative alignment, and complication rates were compared between the groups. Results: Mean preoperative mechanical tibiofemoral angle was 20.1° in varus alignment, and was restored to 4.6° in valgus postoperatively. No statistically significant differences were found between PCL-stabilizing and PCL-retaining groups when KS knee scores, function scores, and flexion arc were evaluated. Two patients in PCL-retaining group underwent revision surgery due to aseptic loosening of tibial component. One patient in PCL-stabilizing group needed arthrotomy due to patellar clunk syndrome. Conclusion: There were no notable differences between the 2 groups and PCL-retaining design had outcomes as good as PCL-stabilizing total knee implant in osteoarthritic knees with severe varus deformity. Level of evidence: Level III, Therapeutic study. Keywords: Posterior cruciate ligament-retaining, Posterior cruciate ligament-stabilization, Total knee arthroplasty, Varus deformity