Vishnu R L, Datta Barun, Prasad Rupesh, Vishnuprasad R
Department of Orthopedic Surgery, Military Hospital, Tezpur, Assam 784001 India.
Department of Orthopedics and Joint Replacement, Army Hospital, Research & Referral, Delhi, India.
Indian J Orthop. 2024 Oct 21;59(1):47-53. doi: 10.1007/s43465-024-01277-2. eCollection 2025 Jan.
Cruciate retaining and posterior stabilizing knee systems are frequently used in total knee replacements. Most researchers compare the results of Cruciate Retaining (CR) and Posterior Stabilizing (PS) knees with those of a control group. The results of using both knee systems in a single patient in simultaneous Total Knee Arthroplasty (TKA) have been studied less.
A total of 50 patients with primary bilateral osteoarthritis with varus which is not fixed and valgus deformity of not more than 10 degrees, age between 55 and 85 years, BMI < 35 kg/m, ASA I or II, and non-inflammatory arthritis were taken up for simultaneous bilateral TKR with one-side CR and other-sided PS surgeries. Patients were followed up periodically at 6 weeks, 3 months, 6 months, and 1 year with Knee Society Score (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Differences in scores were tested with the help of an independent sample Student's test. A p value of less than 0.05 was considered statistically significant.
During the first 6 weeks after surgery, mean KSS was lower in PS knees, though statistically not significant, this difference reduced considerably over a while. By the end of the 1-year post-surgical intervention, KSS was similar among both knees. WOMAC score was similar between CR and PS preoperatively as well as during the entire post-operative follow-up period.
Functional outcomes, patient-reported outcomes, and objective knee indicators in one-sided cruciate-retaining and other-sided posterior stabilizing total replacement in bilateral simultaneous two-team surgery were similar between both knees.
保留交叉韧带和后稳定型膝关节系统常用于全膝关节置换术。大多数研究人员将保留交叉韧带（CR）和后稳定型（PS）膝关节的结果与对照组进行比较。在同一患者中同时进行全膝关节置换术（TKA）时使用这两种膝关节系统的结果研究较少。
共纳入50例原发性双侧膝关节骨关节炎患者，内翻畸形不固定且外翻畸形不超过10度，年龄在55至85岁之间，BMI<35kg/m²，美国麻醉医师协会（ASA）分级为I或II级，且为非炎性关节炎，进行双侧同期TKR手术，一侧采用CR手术，另一侧采用PS手术。在术后6周、3个月、6个月和1年定期对患者进行随访，采用膝关节协会评分（KSS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分。借助独立样本t检验对评分差异进行检验。p值小于0.05被认为具有统计学意义。
术后前6周，PS膝关节的平均KSS较低，尽管在统计学上无显著差异，但随着时间推移这种差异显著减小。到术后1年干预结束时，双侧膝关节的KSS相似。CR和PS术前及整个术后随访期间的WOMAC评分相似。
在双侧同期两组手术中，一侧保留交叉韧带而另一侧采用后稳定型的全膝关节置换术，其功能结局、患者报告结局和客观膝关节指标在双侧膝关节之间相似。
