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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2017

22.09.2016 | Knee

No difference in range of motion between ultracongruent and posterior stabilized design in total knee arthroplasty: a randomized controlled trial

verfasst von: Jörg Lützner, Franziska Beyer, Julian Dexel, Hagen Fritzsche, Cornelia Lützner, Stephan Kirschner

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 11/2017

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Abstract

Purpose

The use of an ultracongruent (UC) insert with a standard femoral component for substitution of the posterior cruciate ligament (PCL) is a bone-preserving and therefore interesting alternative to the established box and cam mechanism of posterior stabilized (PS) total knee arthroplasty (TKA). This study investigated range of motion (ROM), stability and patient-reported outcome (PRO) in UC and PS TKA. We hypothesized better knee flexion with the PS design but no difference in stability and PRO between UC and PS TKA.

Methods

A randomized controlled study was performed. One hundred and twenty-seven patients were included, 63 with an UC and 64 with a PS TKA (Columbus, Aesculap, Tuttlingen, Germany). Intraoperative stability and range of motion was measured with the use of a navigation system. Patients were assessed before surgery, 3 months and 1 year postoperatively.

Results

There was no difference in ROM between both groups, neither intraoperatively nor at follow-up. There was 5 mm less sagittal translation at 90° of knee flexion (p < 0.001) and more posterior femoral rollback during knee flexion in the PS TKA. Axial rotation between extension and knee flexion was reduced by both designs. UC TKA was 7 min faster (p = 0.001). At the one-year follow-up, the Knee Society Score was similar in both groups, the Oxford Knee Score demonstrated better results in the UC TKA group (p = 0.048).

Conclusion

Increased intraoperative sagittal translation and reduced posterior femoral rollback during knee flexion of UC TKA seem to have no negative influence on short-term clinical outcome. Therefore, UC TKA seems to be a practical alternative to the established PS TKA for substitution of the PCL. This might be especially interesting for surgeons who do not always substitute the PCL.

Level of evidence

I.
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Metadaten
Titel
No difference in range of motion between ultracongruent and posterior stabilized design in total knee arthroplasty: a randomized controlled trial
verfasst von
Jörg Lützner
Franziska Beyer
Julian Dexel
Hagen Fritzsche
Cornelia Lützner
Stephan Kirschner
Publikationsdatum
22.09.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 11/2017
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4331-7

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