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. 2022 Nov 5;11(21):6569.
doi: 10.3390/jcm11216569.

No Significant Differences in Clinical and Radiographic Outcomes between PCL Retained or Sacrificed Kinematic Aligned Medial Pivot Total Knee Arthroplasty in Varus Knee

Fortunato Giustra  1 , Francesco Bosco  1 , Giorgio Cacciola  1 , Salvatore Risitano  1 , Marcello Capella  1 , Alessandro Bistolfi  2 , Alessandro Massè  1 , Luigi Sabatini  1
Affiliations

No Significant Differences in Clinical and Radiographic Outcomes between PCL Retained or Sacrificed Kinematic Aligned Medial Pivot Total Knee Arthroplasty in Varus Knee

Fortunato Giustra et al. J Clin Med. .

Abstract

In the last decades, several surgical techniques, such as medial pivot (MP) philosophy and kinematic alignment (KA), have been introduced in total knee arthroplasty (TKA) to improve patients’ outcomes. This retrospective study aims to evaluate the clinical, radiographic, and functional results of PCL preservation or sacrifice in KA MP-TKA. A consecutive series of 147 patients older than 60, with a minimum follow-up of two years, were treated with TKA for severe primary knee osteoarthritis (OA) at the Department of Orthopedics and Traumatology between 1 January 2019, and 1 July 2020. After excluding those not meeting the inclusion criteria, 64 patients were included in the study analysis. Regarding radiographic outcomes, no statistically significant difference was observed between patients with preserved or sacrificed PCL (p > 0.05). A slight improvement in Knee Society Score (KSS), knee and function score, and FJS was observed for the PCL-preserved group, although this superiority tendency was not statistically significant (p > 0.05). PCL-preserved MA MP-TKA reported a statistically significant result in only two questions on the FJS questionnaire (p < 0.05). A slight, non-statistically significant improvement in active ROM was found in the PCL-sacrificed group (p > 0.05). No interventions or revisions were reported in this case series for all treated patients at the final follow-up. No significant differences were described in clinical, radiographic, and functional outcomes in preserved or sacrificed PCL KA MP-TKA. Although not significant, a slight trend toward better clinical outcomes was reported in PCL-preserved KA MP-TKA.

Keywords: KA; MP; PCL; TKA; kinematic alignment; medial pivot; retain; sacrifice; total knee replacement.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The posterior cruciate ligament (PCL) was preserved during tibial cutting.
Figure 2
Figure 2
Flow diagram of study: all patients. TKA: total knee arthroplasty; KA MP-TKA: kinematic alignment medial pivot- total knee arthroplasty; PCL: posterior cruciate ligament.
Figure 3
Figure 3
Radiographs of the patient’s knee before (A) and after KA MP-TKA (B).
See this image and copyright information in PMC

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