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Higher revision rate for posterior cruciate-retaining than posterior-stabilized total knee arthroplasty for the treatment of valgus osteoarthritis

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

Determining the point at which a valgus deformity requires a more invasive therapy—in this case PS TKA—is surgically challenging. Retaining the posterior cruciate ligament has both advantages and disadvantages. The aim was to evaluate the failure rate and clinical outcomes.

Methods

248 patients with valgus gonarthrosis underwent surgical treatment: 167 CR TKA cases and 81 PS TKA cases. The KOOS and the OKS were recorded, and 201 patients (133 CR, 68 PS) were recruited into the retrospective study. The influence of BMI and degree of preoperative valgus deformity on the clinical outcome was determined. The revision rate was documented and analysed.

Results

Of 201 patients, 10 required revision surgery owing to instability (10/133 CR, 0/68 PS). Based on the KOOS and the OKS, no significant difference between CR TKA and PS TKA was found. BMI and degree of valgus deformity had no effect on the clinical outcome.

Conclusions

No difference in the clinical outcome between the CR and PS TKA patients was found. In the CR group, significantly more patients showed ‘excellent’ OKS than in the PS group. However, 8.0% of the patients in the CR group and none in the PS group underwent surgery due to instability. A higher rate of dissatisfied patients in the CR group is likely. In our clinic, we no longer perform CR TKA for valgus cases.

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Abbreviations

ADL:

Activities of daily living

CR:

Cruciate-retaining

ITB:

Iliotibial band

KOOS:

Knee injury and Osteoarthritis Outcome Score

LCL:

Lateral collateral ligament

MCL:

Medial collateral ligament

OKS:

Oxford Knee Score

PCL:

Posterior cruciate ligament

PLC:

Posterolateral capsule

POP:

Popliteal tendon

PS:

Posterior-stabilized

QOL:

Quality of life

RCT:

Randomized controlled trial

TKA:

Total knee arthroplasty

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Author notes

  1. Peter Savov and Evelyn Mielke contributed equal to this manuscript.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625, Hanover, Germany

    Peter Savov, Evelyn Mielke, Henning Windhagen, Alena Richter & Max Ettinger

  2. Articon Christenorto AG, Schänzlistrasse 39, 3013, Bern, Switzerland

    Tilman Calliess

Authors
  1. Peter Savov
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  2. Evelyn Mielke
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Contributions

EM carried out the data acquisition and have been involved in drafting the manuscript. PS performed the statistical analysis, interpretation of data and have been involved in drafting the manuscript. ME has made substantial contributions to conception and design, interpretation of data and drafting and revising the manuscript. TC was involved in conception and design as well as revising the manuscript. AR was involved in data acquisition and drafting the manuscript. HW was involved in revising the manuscript and give final approval of the version to be published.

Corresponding authors

Correspondence to Peter Savov or Max Ettinger.

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The authors declare that they have no conflict of interest.

Ethical approval

The local ethical board approved this retrospective non-invasive pilot-study.

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Informed consent was obtained from all individual participants included in the study.

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Savov, P., Mielke, E., Windhagen, H. et al. Higher revision rate for posterior cruciate-retaining than posterior-stabilized total knee arthroplasty for the treatment of valgus osteoarthritis. Arch Orthop Trauma Surg 141, 305–312 (2021). https://doi.org/10.1007/s00402-020-03618-w

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