Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2014 Jul 19:9:54.
doi: 10.1186/s13018-014-0054-y.

Primary posterior stabilized total knee arthroplasty: analysis of different instrumentation

Pier Francesco Indelli, Massimiliano Marcucci, Angelo Graceffa, Sophie Charlton, Leonardo Latella
Comparative Study

Primary posterior stabilized total knee arthroplasty: analysis of different instrumentation

Pier Francesco Indelli et al. J Orthop Surg Res. .

Abstract

Background: Intercondylar femoral bone removal during posterior stabilized (PS) total knee arthroplasty (TKA) makes many cruciate substituting implant designs less appealing than cruciate retaining implants. Bone stock conservation is considered fundamental in the prevision of future revision surgeries. The purpose of this study was to compare the quantity of intercondylar bone removable during PS housing preparation using three contemporary PS TKA instrumentations.

Method: We compared different box cutting jigs which were utilized for the PS housing of three popular PS knee prostheses. The bone removal area from every PS box cutting jig was three-dimensionally measured.

Results: Independently from the implant size, the cutting jig for a specific PS TKA always resected significantly less bone than the others: this difference was statistically significant, especially for small- to medium-sized total knee femoral components.

Conclusion: This study does not establish a clinical relevance of removing more or less bone at primary TKA, but suggests that if a PS design is indicated, it is preferable to select a model which possibly resects less distal femoral bone.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Right knee. Intraoperative image of a femoral jig before ‘box osteotomy.’
Figure 2
Figure 2
The De Puy Sigma PS femoral cutting jig (large sizes) is shown. An osteotome defines the bone removable area.
Figure 3
Figure 3
The Vanguard femoral cutting jig (large sizes) is shown. An osteotome defines the bone removable area.
Figure 4
Figure 4
The Persona femoral cutting jig (large sizes) is shown. An osteotome defines the bone removable area.
Figure 5
Figure 5
Bar diagram showing the maximum volumetric bone resection (cm 3 ) for each PS cutting jigs of the tested designs.
See this image and copyright information in PMC

References

    1. Indelli PF, Aglietti P, Buzzi R, Baldini A. The Insall-Burstein II prosthesis: a 5- to 9-year follow-up study in osteoarthritic knees. J Arthroplasty. 2002;17(5):544–549. doi: 10.1054/arth.2002.32186. - DOI - PubMed
    1. Wragg R, Khan RJZ, Damasena ITW. A comparison of bone loss at total knee replacement: posterior stabilized versus cruciate retaining. J Orthopaedics. 2012;9(1):e1.
    1. Becher C, Heyse TJ, Kron N, Ostermeier S, Hurschler C, Schofer MD, Fuchs-Winkelmann S, Tibesku CO. Posterior stabilized TKA reduce patellofemoral contact pressure compared with cruciate retaining TKA in vitro. Knee Surg Sports Traumatol Arthrosc. 2009;17(10):1159–1165. doi: 10.1007/s00167-009-0768-2. - DOI - PubMed
    1. Puloski SK, McCalden RW, MacDonald SJ, Rorabeck CH, Bourne RB. Tibial post wear in posterior stabilized total knee arthroplasty. An unrecognized source of polyethylene debris. J Bone Joint Surg Am. 2001;83-A(3):390–397. - PubMed
    1. Indelli PF, Marcucci M, Pipino G, Charlton S, Carulli C, Innocenti M. The effects of femoral component design on the patello-femoral joint in a PS total knee arthroplasty. Arch Orthop Trauma Surg. 2013;134:59–64. doi: 10.1007/s00402-013-1877-4. [Epub ahead of print] - DOI - PubMed

Publication types

MeSH terms