A Randomized Clinical Trial Comparing Posterior Cruciate-Stabilizing vs Posterior Cruciate-Retaining Prostheses in Primary Total Knee Arthroplasty: 10-Year Follow-Up.

BACKGROUND

This 10-year follow-up compares health-related quality of life (HRQL) and reoperations in 100 subjects who were randomized to receive posterior cruciate ligament substituting (PS) or posterior cruciate ligament retaining (CR) total knee arthroplasty. We previously reported 2-year results.

METHODS

Subjects were enrolled preoperatively and randomized at surgery. Subjects completed HRQL questionnaires at all evaluation points. Subjects were re-evaluated at 2 and 10 years with reoperations determined through regional medical record review and patient report.

RESULTS

Over 10 years, 25 (25%) subjects died, 2 subjects were revised and withdrew, and 11 (11%) subjects were lost to follow-up. Of survivors, 62 of 75 (83%) were evaluated at 10 years. Twenty-eight (37%) subjects provided HRQL, radiographic, and reoperation status, 28 (37%) subjects completed HRQL evaluations and reoperation status only, and 6 (8%) subjects provided radiographic and reoperation follow-up. Both groups retained good HRQL between 2 and 10 years with no group differences noted (P > .35). One revision (CR subject), secondary to deep joint infection, occurred within 2 years with 1 further revision (PS subject) occurring at 3 years postoperatively. One subject (PS subject) required manipulation under anesthesia within 3 months of surgery. Four subjects required late patellar resurfacing (1 CR subject, 3 PS subjects) but were retained in the 10-year evaluation. Overall, reoperations were not significantly different between groups (P = .26).

CONCLUSION

Over 10 years postoperatively, both the PS and CR total knee arthroplasty performed well with subjects reporting acceptable levels of HRQL up to 10 years postoperatively; low levels of revision or reoperation were reported in both groups.