Vinciguerra B, Pascarel X, Honton J L
Service d'Orthopédie-Traumatologie, Hôpital Pellegrin-Tripode, Bordeaux.
Rev Chir Orthop Reparatrice Appar Mot. 1994;80(7):620-5.
This study was undertaken to assess the functional repercussion of retention or sacrifice of the posterior cruciate ligament in total knee replacement.
Two homogeneous randomised series of 24 cases were matched. They concerned primary total knee arthroplasty for osteoarthritis using the same prosthetic design. In case of sacrifice of the posterior cruciate ligament, the prosthesis included a substitution system constituting the only difference between the two types of implants (the design of trochlea, femoral condyle and tibial plateau were identical).
Functional assessment was performed according to the Hospital for Special Surgery score, at a minimal follow up of 12 months. The Student "t" Test was used for statistical analysis.
In cases with posterior cruciate retention, the mean HSS score was 86.6. In postero-stabilised cases. this score was 87.7: a non significant difference. The mean range of flexion was 108 degrees for the retaining cases versus 113 degrees for the postero-stabilised ones: a non significant difference.
The functional outcome seems to be the same whether a postero-stabilised or a posterior cruciate retaining total knee prosthesis was used. The latter technique requires more care for ligament balancing, tibial cuts and exposure.
The authors believe that there is no benefit to expect at mid-term follow up from retaining the posterior cruciate ligament in total knee replacement.
本研究旨在评估全膝关节置换术中保留或牺牲后交叉韧带的功能影响。
将两个各有24例的同质随机系列进行匹配。它们涉及使用相同假体设计治疗骨关节炎的初次全膝关节置换术。在牺牲后交叉韧带的情况下，假体包括一个替代系统，这是两种植入物之间唯一的区别（滑车、股骨髁和胫骨平台的设计相同）。
根据特殊外科医院评分进行功能评估，最短随访12个月。采用学生“t”检验进行统计分析。
保留后交叉韧带的病例中，平均HSS评分为86.6。在后稳定型病例中，该评分为87.7：差异无统计学意义。保留后交叉韧带病例的平均屈曲范围为108度，后稳定型病例为113度：差异无统计学意义。
使用后稳定型或保留后交叉韧带的全膝关节假体，功能结果似乎相同。后一种技术在韧带平衡、胫骨截骨和暴露方面需要更多的注意。
作者认为，在全膝关节置换术中保留后交叉韧带，中期随访时不会有预期的益处。
