Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2011

01.07.2011 | Knee

Anteroposterior stability after posterior cruciate-retaining total knee arthroplasty

verfasst von: A. J. Schuster, A. L. von Roll, D. Pfluger, T. Wyss

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 7/2011

Einloggen, um Zugang zu erhalten

Abstract

Purpose

A functional posterior cruciate ligament (PCL) is important for the knee stability after PCL-retaining total knee arthroplasty (TKA). The objectives of this study were to determine the anteroposterior (AP) displacement of the knee after a mobile- or fixed-bearing PCL-retaining TKA operated with a ligament-balancing technique and the correlation of AP stability with the clinical outcome.

Methods

The AP displacement of 160 TKAs in 143 patients was measured pre- and intra-operatively, and the results were compared to the AP displacement measured 4 years post-surgery.

Results

The change in AP displacement from intra-operative measurement to follow-up at the 25° measuring point was −1.2 mm; at 90°, it was −0.2 mm. Mobile bearings showed significantly greater AP displacement than fixed bearings. Older patients, male patients and patients receiving a fixed prosthesis had lower post-operative laxity compared with the overall population.

Conclusions

The small change in AP displacement indicates that the PCL remains functional over time. In our study, we could not find any correlation between knee AP stability and clinical outcome, including passive flexion, Knee Society Score or Visual Analogue Scale of pain and satisfaction.

Level of evidence

IV.
Literatur
1.
Zurück zum Zitat Akasaki Y, Matsuda S, Miura H, Okazaki K, Moro-oka TA, Mizu-Uchi H, Iwamoto Y (2009) Total knee arthroplasty following failed high tibial osteotomy: mid-term comparison of posterior cruciate-retaining versus posterior stabilized prosthesis. Knee Surg Sports Traumatol Arthrosc 17:795–799PubMedCrossRef Akasaki Y, Matsuda S, Miura H, Okazaki K, Moro-oka TA, Mizu-Uchi H, Iwamoto Y (2009) Total knee arthroplasty following failed high tibial osteotomy: mid-term comparison of posterior cruciate-retaining versus posterior stabilized prosthesis. Knee Surg Sports Traumatol Arthrosc 17:795–799PubMedCrossRef
2.
Zurück zum Zitat Balasch H, Schiller M, Friebel H, Hoffmann F (1999) Evaluation of anterior knee joint instability with the Rolimeter. A test in comparison with manual assessment and measuring with the KT-1000 arthrometer. Knee Surg Sports Traumatol Arthrosc 7:204–208PubMedCrossRef Balasch H, Schiller M, Friebel H, Hoffmann F (1999) Evaluation of anterior knee joint instability with the Rolimeter. A test in comparison with manual assessment and measuring with the KT-1000 arthrometer. Knee Surg Sports Traumatol Arthrosc 7:204–208PubMedCrossRef
3.
Zurück zum Zitat Banks SA, Hodge WA (2004) Implant design affects knee arthroplasty kinematics during stair-stepping. Clin Orthop Relat Res 426:187–193PubMedCrossRef Banks SA, Hodge WA (2004) Implant design affects knee arthroplasty kinematics during stair-stepping. Clin Orthop Relat Res 426:187–193PubMedCrossRef
4.
Zurück zum Zitat Becher C, Heyse TJ, Kron N, Ostermeier S, Hurschler C, Schofer MD, Fuchs-Winkelmann S, Tibesku CO (2009) Posterior stabilized TKA reduce patellofemoral contact pressure compared with cruciate retaining TKA in vitro. Knee Surg Sports Traumatol Arthrosc 17:1159–1165PubMedCrossRef Becher C, Heyse TJ, Kron N, Ostermeier S, Hurschler C, Schofer MD, Fuchs-Winkelmann S, Tibesku CO (2009) Posterior stabilized TKA reduce patellofemoral contact pressure compared with cruciate retaining TKA in vitro. Knee Surg Sports Traumatol Arthrosc 17:1159–1165PubMedCrossRef
5.
Zurück zum Zitat Besson A, Brazier J, Chantelot C, Migaud H, Gougeon F, Duquennoy A (1999) Laxity and functional results of Miller-Galante total knee prosthesis with posterior cruciate ligament sparing after a 6 year follow-up. Rev Chir Orthop Reparatrice Appar Mot 85:797–802PubMed Besson A, Brazier J, Chantelot C, Migaud H, Gougeon F, Duquennoy A (1999) Laxity and functional results of Miller-Galante total knee prosthesis with posterior cruciate ligament sparing after a 6 year follow-up. Rev Chir Orthop Reparatrice Appar Mot 85:797–802PubMed
6.
Zurück zum Zitat Callahan CM, Drake BG, Heck DA, Dittus RS (1994) Patient outcomes following tricompartmental total knee replacement. A meta-analysis. JAMA 271:1349–1357PubMedCrossRef Callahan CM, Drake BG, Heck DA, Dittus RS (1994) Patient outcomes following tricompartmental total knee replacement. A meta-analysis. JAMA 271:1349–1357PubMedCrossRef
7.
Zurück zum Zitat Christen B, Heesterbeek P, Wymenga A, Wehrli U (2007) Posterior cruciate ligament balancing in total knee replacement: the quantitative relationship between tightness of the flexion gap and tibial translation. J Bone Joint Surg Br 89:1046–1050PubMedCrossRef Christen B, Heesterbeek P, Wymenga A, Wehrli U (2007) Posterior cruciate ligament balancing in total knee replacement: the quantitative relationship between tightness of the flexion gap and tibial translation. J Bone Joint Surg Br 89:1046–1050PubMedCrossRef
8.
Zurück zum Zitat Cloutier JM, Sabouret P, Deghrar A (1999) Total knee arthroplasty with retention of both cruciate ligaments. A nine to eleven-year follow-up study. J Bone Joint Surg Am 81:697–702PubMed Cloutier JM, Sabouret P, Deghrar A (1999) Total knee arthroplasty with retention of both cruciate ligaments. A nine to eleven-year follow-up study. J Bone Joint Surg Am 81:697–702PubMed
9.
Zurück zum Zitat Dejour D, Deschamps G, Garotta L, Dejour H (1999) Laxity in posterior cruciate sparing and posterior stabilized total knee prostheses. Clin Orthop Relat Res 364:182–193PubMedCrossRef Dejour D, Deschamps G, Garotta L, Dejour H (1999) Laxity in posterior cruciate sparing and posterior stabilized total knee prostheses. Clin Orthop Relat Res 364:182–193PubMedCrossRef
10.
Zurück zum Zitat Delport HP, Banks SA, De SJ, Bellemans J (2006) A kinematic comparison of fixed- and mobile-bearing knee replacements. J Bone Joint Surg Br 88:1016–1021PubMedCrossRef Delport HP, Banks SA, De SJ, Bellemans J (2006) A kinematic comparison of fixed- and mobile-bearing knee replacements. J Bone Joint Surg Br 88:1016–1021PubMedCrossRef
11.
Zurück zum Zitat Dennis DA, Komistek RD, Kim RH, Sharma A (2010) Gap balancing versus measured resection technique for total knee arthroplasty. Clin Orthop Relat Res 468:102–107PubMedCrossRef Dennis DA, Komistek RD, Kim RH, Sharma A (2010) Gap balancing versus measured resection technique for total knee arthroplasty. Clin Orthop Relat Res 468:102–107PubMedCrossRef
12.
Zurück zum Zitat Freeman MA (1997) Soft tissues: a question of balance. Orthopedics 20:827–831PubMed Freeman MA (1997) Soft tissues: a question of balance. Orthopedics 20:827–831PubMed
13.
Zurück zum Zitat Fukagawa S, Matsuda S, Tashiro Y, Hashizume M, Iwamoto Y (2010) Posterior displacement of the tibia increases in deep flexion of the knee. Clin Orthop Relat Res 468:1107–1114PubMedCrossRef Fukagawa S, Matsuda S, Tashiro Y, Hashizume M, Iwamoto Y (2010) Posterior displacement of the tibia increases in deep flexion of the knee. Clin Orthop Relat Res 468:1107–1114PubMedCrossRef
14.
Zurück zum Zitat Ganko A, Engebretsen L, Ozer H (2000) The rolimeter: a new arthrometer compared with the KT-1000. Knee Surg Sports Traumatol Arthrosc 8:36–39PubMedCrossRef Ganko A, Engebretsen L, Ozer H (2000) The rolimeter: a new arthrometer compared with the KT-1000. Knee Surg Sports Traumatol Arthrosc 8:36–39PubMedCrossRef
15.
Zurück zum Zitat Georgoulis AD, Papageorgiou CD, Makris CA, Moebius UG, Soucacos PN (1997) Anterior cruciate ligament reconstruction with the press-fit technique. 2–5 years followed-up of 42 patients. Acta Orthop Scand Suppl 275:42–45PubMed Georgoulis AD, Papageorgiou CD, Makris CA, Moebius UG, Soucacos PN (1997) Anterior cruciate ligament reconstruction with the press-fit technique. 2–5 years followed-up of 42 patients. Acta Orthop Scand Suppl 275:42–45PubMed
16.
Zurück zum Zitat Heesterbeek PJ, Keijsers NL, Wymenga AB (2010) Ligament releases do not lead to increased postoperative varus-valgus laxity in flexion and extension: a prospective clinical study in 49 TKR patients. Knee Surg Sports Traumatol Arthrosc 18:187–193PubMedCrossRef Heesterbeek PJ, Keijsers NL, Wymenga AB (2010) Ligament releases do not lead to increased postoperative varus-valgus laxity in flexion and extension: a prospective clinical study in 49 TKR patients. Knee Surg Sports Traumatol Arthrosc 18:187–193PubMedCrossRef
17.
Zurück zum Zitat Ishii Y, Matsuda Y, Ishii R, Sakata S, Omori G (2005) Sagittal laxity in vivo after total knee arthroplasty. Arch Orthop Trauma Surg 125:249–253PubMedCrossRef Ishii Y, Matsuda Y, Ishii R, Sakata S, Omori G (2005) Sagittal laxity in vivo after total knee arthroplasty. Arch Orthop Trauma Surg 125:249–253PubMedCrossRef
18.
Zurück zum Zitat Jacobs WC, Clement DJ, Wymenga AB (2005) Retention versus removal of the posterior cruciate ligament in total knee replacement: a systematic literature review within the Cochrane framework. Acta Orthop 76:757–768PubMedCrossRef Jacobs WC, Clement DJ, Wymenga AB (2005) Retention versus removal of the posterior cruciate ligament in total knee replacement: a systematic literature review within the Cochrane framework. Acta Orthop 76:757–768PubMedCrossRef
19.
Zurück zum Zitat Jones DP, Locke C, Pennington J, Theis JC (2006) The effect of sagittal laxity on function after posterior cruciate-retaining total knee replacement. J Arthroplasty 21:719–723PubMedCrossRef Jones DP, Locke C, Pennington J, Theis JC (2006) The effect of sagittal laxity on function after posterior cruciate-retaining total knee replacement. J Arthroplasty 21:719–723PubMedCrossRef
20.
Zurück zum Zitat Kelly MA, Clarke HD (2002) Long-term results of posterior cruciate-substituting total knee arthroplasty. Clin Orthop Relat Res 404:51–57PubMedCrossRef Kelly MA, Clarke HD (2002) Long-term results of posterior cruciate-substituting total knee arthroplasty. Clin Orthop Relat Res 404:51–57PubMedCrossRef
21.
Zurück zum Zitat Mahoney OM, Noble PC, Rhoads DD, Alexander JW, Tullos HS (1994) Posterior cruciate function following total knee arthroplasty. A biomechanical study. J Arthroplasty 9:569–578PubMedCrossRef Mahoney OM, Noble PC, Rhoads DD, Alexander JW, Tullos HS (1994) Posterior cruciate function following total knee arthroplasty. A biomechanical study. J Arthroplasty 9:569–578PubMedCrossRef
22.
Zurück zum Zitat Markolf KL, Graff-Radford A, Amstutz HC (1978) In vivo knee stability. A quantitative assessment using an instrumented clinical testing apparatus. J Bone Joint Surg Am 60:664–674PubMed Markolf KL, Graff-Radford A, Amstutz HC (1978) In vivo knee stability. A quantitative assessment using an instrumented clinical testing apparatus. J Bone Joint Surg Am 60:664–674PubMed
23.
Zurück zum Zitat Matsuda S, Miura H, Nagamine R, Urabe K, Matsunobu T, Iwamoto Y (1999) Knee stability in posterior cruciate ligament retaining total knee arthroplasty. Clin Orthop Relat Res 366:169–173PubMedCrossRef Matsuda S, Miura H, Nagamine R, Urabe K, Matsunobu T, Iwamoto Y (1999) Knee stability in posterior cruciate ligament retaining total knee arthroplasty. Clin Orthop Relat Res 366:169–173PubMedCrossRef
24.
Zurück zum Zitat Matsuda S, Whiteside LA, White SE, McCarthy DS (1999) Knee stability in meniscal bearing total knee arthroplasty. J Arthroplasty 14:82–90PubMedCrossRef Matsuda S, Whiteside LA, White SE, McCarthy DS (1999) Knee stability in meniscal bearing total knee arthroplasty. J Arthroplasty 14:82–90PubMedCrossRef
25.
Zurück zum Zitat Morberg P, Chapman-Sheath P, Morris P, Cain S, Walsh WR (2002) The function of the posterior cruciate ligament in an anteroposterior-gliding rotating platform total knee arthroplasty. J Arthroplasty 17:484–489PubMedCrossRef Morberg P, Chapman-Sheath P, Morris P, Cain S, Walsh WR (2002) The function of the posterior cruciate ligament in an anteroposterior-gliding rotating platform total knee arthroplasty. J Arthroplasty 17:484–489PubMedCrossRef
26.
Zurück zum Zitat Nabeyama R, Matsuda S, Miura H, Kawano T, Nagamine R, Mawatari T, Tanaka K, Iwamoto Y (2003) Changes in anteroposterior stability following total knee arthroplasty. J Orthop Sci 8:526–531PubMedCrossRef Nabeyama R, Matsuda S, Miura H, Kawano T, Nagamine R, Mawatari T, Tanaka K, Iwamoto Y (2003) Changes in anteroposterior stability following total knee arthroplasty. J Orthop Sci 8:526–531PubMedCrossRef
27.
Zurück zum Zitat Niki Y, Mochizuki T, Momohara S, Saito S, Matsumoto H, Tomatsu T (2008) Factors affecting anteroposterior instability following cruciate-retaining total knee arthroplasty in patients with rheumatoid arthritis. Knee 15:26–30PubMedCrossRef Niki Y, Mochizuki T, Momohara S, Saito S, Matsumoto H, Tomatsu T (2008) Factors affecting anteroposterior instability following cruciate-retaining total knee arthroplasty in patients with rheumatoid arthritis. Knee 15:26–30PubMedCrossRef
28.
Zurück zum Zitat Pagnano MW, Hanssen AD, Lewallen DG, Stuart MJ (1998) Flexion instability after primary posterior cruciate retaining total knee arthroplasty. Clin Orthop Relat Res 356:39–46PubMedCrossRef Pagnano MW, Hanssen AD, Lewallen DG, Stuart MJ (1998) Flexion instability after primary posterior cruciate retaining total knee arthroplasty. Clin Orthop Relat Res 356:39–46PubMedCrossRef
29.
Zurück zum Zitat Pellengahr C, Jansson V, Durr HR, Refior HJ (1999) Significance of sagittal stability in knee prosthesis implantation–an analysis of 76 cases with unconstrained joint surface replacement. Z Orthop Ihre Grenzgeb 137:330–333PubMedCrossRef Pellengahr C, Jansson V, Durr HR, Refior HJ (1999) Significance of sagittal stability in knee prosthesis implantation–an analysis of 76 cases with unconstrained joint surface replacement. Z Orthop Ihre Grenzgeb 137:330–333PubMedCrossRef
30.
Zurück zum Zitat Rand JA, Ilstrup DM (1991) Survivorship analysis of total knee arthroplasty. Cumulative rates of survival of 9200 total knee arthroplasties. J Bone Joint Surg Am 73:397–409PubMed Rand JA, Ilstrup DM (1991) Survivorship analysis of total knee arthroplasty. Cumulative rates of survival of 9200 total knee arthroplasties. J Bone Joint Surg Am 73:397–409PubMed
31.
Zurück zum Zitat Rand JA, Trousdale RT, Ilstrup DM, Harmsen WS (2003) Factors affecting the durability of primary total knee prostheses. J Bone Joint Surg Am 85-A:259–265PubMed Rand JA, Trousdale RT, Ilstrup DM, Harmsen WS (2003) Factors affecting the durability of primary total knee prostheses. J Bone Joint Surg Am 85-A:259–265PubMed
32.
Zurück zum Zitat Sextro GS, Berry DJ, Rand JA (2001) Total knee arthroplasty using cruciate-retaining kinematic condylar prosthesis. Clin Orthop Relat Res 388:33–40PubMedCrossRef Sextro GS, Berry DJ, Rand JA (2001) Total knee arthroplasty using cruciate-retaining kinematic condylar prosthesis. Clin Orthop Relat Res 388:33–40PubMedCrossRef
33.
Zurück zum Zitat Stern SH, Insall JN (1992) Posterior stabilized prosthesis. Results after follow-up of nine to twelve years. J Bone Joint Surg Am 74:980–986PubMed Stern SH, Insall JN (1992) Posterior stabilized prosthesis. Results after follow-up of nine to twelve years. J Bone Joint Surg Am 74:980–986PubMed
34.
Zurück zum Zitat Straw R, Kulkarni S, Attfield S, Wilton TJ (2003) Posterior cruciate ligament at total knee replacement. Essential, beneficial or a hindrance? J Bone Joint Surg Br 85:671–674PubMed Straw R, Kulkarni S, Attfield S, Wilton TJ (2003) Posterior cruciate ligament at total knee replacement. Essential, beneficial or a hindrance? J Bone Joint Surg Br 85:671–674PubMed
35.
Zurück zum Zitat van Hal CT, van Hellemondt GG, Wymenga AB, Jacobs WC (2007) The anterior-posterior laxity after total knee arthroplasty inserted with a ligament tensor. Knee Surg Sports Traumatol Arthrosc 15:1019–1022PubMedCrossRef van Hal CT, van Hellemondt GG, Wymenga AB, Jacobs WC (2007) The anterior-posterior laxity after total knee arthroplasty inserted with a ligament tensor. Knee Surg Sports Traumatol Arthrosc 15:1019–1022PubMedCrossRef
36.
Zurück zum Zitat Victor J, Banks S, Bellemans J (2005) Kinematics of posterior cruciate ligament-retaining and -substituting total knee arthroplasty: a prospective randomised outcome study. J Bone Joint Surg Br 87:646–655PubMedCrossRef Victor J, Banks S, Bellemans J (2005) Kinematics of posterior cruciate ligament-retaining and -substituting total knee arthroplasty: a prospective randomised outcome study. J Bone Joint Surg Br 87:646–655PubMedCrossRef
37.
Zurück zum Zitat Warren PJ, Olanlokun TK, Cobb AG, Walker PS, Iverson BF (1994) Laxity and function in knee replacements. A comparative study of three prosthetic designs. Clin Orthop Relat Res 305:200–208PubMedCrossRef Warren PJ, Olanlokun TK, Cobb AG, Walker PS, Iverson BF (1994) Laxity and function in knee replacements. A comparative study of three prosthetic designs. Clin Orthop Relat Res 305:200–208PubMedCrossRef
38.
Zurück zum Zitat Waslewski GL, Marson BM, Benjamin JB (1998) Early, incapacitating instability of posterior cruciate ligament-retaining total knee arthroplasty. J Arthroplasty 13:763–767PubMedCrossRef Waslewski GL, Marson BM, Benjamin JB (1998) Early, incapacitating instability of posterior cruciate ligament-retaining total knee arthroplasty. J Arthroplasty 13:763–767PubMedCrossRef
39.
Zurück zum Zitat Wyss T, Schuster AJ, Christen B, Wehrli U (2008) Tension controlled ligament balanced total knee arthroplasty: 5 year results of a soft tissue orientated surgical technique. Arch Orthop Trauma Surg 128:129–135PubMedCrossRef Wyss T, Schuster AJ, Christen B, Wehrli U (2008) Tension controlled ligament balanced total knee arthroplasty: 5 year results of a soft tissue orientated surgical technique. Arch Orthop Trauma Surg 128:129–135PubMedCrossRef
40.
Zurück zum Zitat Yamakado K, Kitaoka K, Yamada H, Hashiba K, Nakamura R, Tomita K (2003) Influence of stability on range of motion after cruciate-retaining TKA. Arch Orthop Trauma Surg 123:1–4PubMed Yamakado K, Kitaoka K, Yamada H, Hashiba K, Nakamura R, Tomita K (2003) Influence of stability on range of motion after cruciate-retaining TKA. Arch Orthop Trauma Surg 123:1–4PubMed
Metadaten
Titel
Anteroposterior stability after posterior cruciate-retaining total knee arthroplasty
verfasst von
A. J. Schuster
A. L. von Roll
D. Pfluger
T. Wyss
Publikationsdatum
01.07.2011
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 7/2011
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-010-1364-1

Weitere Artikel der Ausgabe 7/2011

Knee Surgery, Sports Traumatology, Arthroscopy 7/2011 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.