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Review
. 2024 Oct 9:61:97-102.
doi: 10.1016/j.jor.2024.10.002. eCollection 2025 Mar.

The performance of cruciate-retaining implants for primary total knee arthroplasty in valgus deformed knees: A systematic review

Peter A Falgiano  1 , John J Heifner  1 , Thomas O Yergler  2 , Christopher Guerra  2 , Arturo Corces  2
Affiliations
Review

The performance of cruciate-retaining implants for primary total knee arthroplasty in valgus deformed knees: A systematic review

Peter A Falgiano et al. J Orthop. .

Abstract

Background: Valgus deformity of the knee comprises upwards of 15 % of the deformities in primary total knee arthroplasty (TKA) patients. 1,2 The two implants most commonly used in valgus deformed knees are posterior stabilizing (PS) and cruciate-retaining (CR) implants. CR implants may offer a more advantageous construct due to the retention of the PCL for proprioception and less bony resection compared to PS implants. The purpose of this systematic review is to aggregate findings for cruciate-retaining implants used in primary TKA with valgus deformed knees.

Methods: In compliance with PRISMA guidelines, databases were queried for CR TKA studies which met the inclusion criteria. Cochrane ROBINS-I and the GRADE framework assessed bias and quality respectively.

Results: There was a statistically significant (p < 0.001) difference between preoperative and postoperative valgus deformity as measured by tibiofemoral angle. The all-cause revision rate was 8.3 % in our sample of 710 total knee arthroplasties.

Conclusion: This review of the literature demonstrates that, although scarcely reported, cruciate-retaining implants used in primary total knee arthroplasties in valgus deformed knees provide satisfactory outcomes such as arc of motion and knee score. Our results demonstrate a significant increase in all-cause revision when using CR implants for valgus deformed knee. For this reason, further investigations should be conducted to evaluate modes of failure in this specific patient population.

Level of evidence: IV systematic review.

Keywords: Cruciate-retaining; Posterior stabilizing; Tibiofemoral angle; Total knee arthroplasty; Valgus knee.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. AC discloses consultant relationship with Exactech and royalties with Arthrex. All other authors declare that they have no competing interests.

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