Good Hope and Solihull Hospitals, Heart of England NHS Foundation Trust, Birmingham, UK.
Knee Surg Sports Traumatol Arthrosc. 2011 Jun;19(6):893-8. doi: 10.1007/s00167-010-1234-x. Epub 2010 Sep 1.
Total knee arthroplasty (TKA) is typically carried out either with retention (CR) of the posterior cruciate ligament (PCL) or with sacrifice of this ligament and implantation of a posterior stabilised (PS) prosthesis. This paper investigates a comparison of PCL function in knees treated for osteoarthritis with TKA where the PCL is preserved to those knees treated with TKA and posterior stabilisation.
One hundred and sixty-eight patients (232 knees) who had undergone TKA with either a PS or CR implant were included in the study. Clinical assessment included antero-posterior (AP) laxity and posterior sag assessment with an arthrometer.
The mean AP laxity at 90° of flexion for CR TKAs was 6.5 mm (±3.1) and was the same [6.5 mm (±2.4)] as in the PS group. However, 56% of the PCL-preserved knees had a posterior sag of over 3 mm compared to 18% of the knees in the PS group. The American Knee Society Scores for either group showed that, although the mean function score was the same, the knee score was superior in the PS group (77 vs. 84). The range of motion was also superior in the PS group (111° vs. 105°).
The use of the PS prosthesis for TKA provides a more predictable outcome with regard to posterior sag and a better maximum flexion than a CR implant.
全膝关节置换术（TKA）通常采用保留（CR）后交叉韧带（PCL）或牺牲该韧带并植入后稳定（PS）假体的方法进行。本文研究了 TKA 治疗骨关节炎时保留 PCL 与 TKA 和后稳定治疗的膝关节中 PCL 功能的比较。
研究纳入了 168 例（232 膝）接受 PS 或 CR 植入物 TKA 的患者。临床评估包括关节测径器测量的前向和后向（AP）松弛度以及后向凹陷评估。
CR TKA 的屈曲 90°时的平均 AP 松弛度为 6.5mm（±3.1），与 PS 组相同[6.5mm（±2.4）]。然而，与 PS 组 18%的膝关节相比，56%的保留 PCL 的膝关节的后向凹陷超过 3mm。两组的美国膝关节协会评分均表明，尽管平均功能评分相同，但 PS 组的膝关节评分更高（77 分比 84 分）。PS 组的活动范围也更大（111°比 105°）。
与 CR 植入物相比，PS 假体用于 TKA 可提供更可预测的后向凹陷和更好的最大屈曲结果。
