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. 2021 Feb;141(2):305-312.
doi: 10.1007/s00402-020-03618-w. Epub 2020 Oct 26.

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

Peter Savov #  1 , Evelyn Mielke #  2 , Henning Windhagen  2 , Tilman Calliess  3 , Alena Richter  2 , Max Ettinger  4
Affiliations

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

Peter Savov et al. Arch Orthop Trauma Surg. 2021 Feb.

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.

Keywords: Cruciate retaining; Posterior stabilized; Sagittal instability; TKA; Valgus.

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