Highlights
- •Total force was similar in the two common types of total knee arthroplasty.
- •Force distribution differed in the two types of total knee arthroplasty.
- •Force in posterior stabilized knees was concentrated in the medial compartment.
- •Force in cruciate retaining knees was well balanced at mid-flexion.
- •Force in cruciate retaining knees shifted to the lateral side at end flexion.
Abstract
Background
Although both the posterior stabilized and cruciate retaining total knee arthroplasty
have been proven to effectively relieve pain and restore basic functions, the joint
gap width during flexion was reported to be different due to the presence or absence
of posterior cruciate ligament, which may lead to different intra-articular force
distribution. In this study, we investigated the distinctions in intra-articular force
distribution between the two types of TKA designs in patients with varus knee osteoarthritis.
Methods
Forty five patients (50 knees) with varus knee osteoarthritis were prospectively included,
with each 25 knees receiving cruciate retaining and posterior stabilized total knee
arthroplasty, respectively. With an intra-articular force measurement system, the
intra-articular force distribution with knee flexion at 0°, 30°, 45°, 60°, 90°, and
120° were recorded in all patients.
Findings
The total force was similar for posterior stabilized and cruciate retaining knees
at all flexion degrees. However, force in the medial compartment accounted for 59.8% –84.0% of total force in posterior stabilized knees, while 27.4% –65.7% in cruciate retaining knees. In cruciate retaining knees, no significant difference
was found between forces in the two compartments at 30° flexion (P = 0.444), but force was significantly concentrated in the lateral side during 45° –120° flexion (P = 0.000– 0.028).
Interpretation
Although the entire intra-articular forces were similar between CR and PS knees at
different flexion angles, medial part had higher force than lateral part when PS knee
was used. The posterior cruciate ligament do a role in soft balance, and make the
force more evenly distributed.
Keywords
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Article info
Publication history
Published online: December 14, 2016
Accepted:
December 13,
2016
Received:
April 6,
2016
Identification
Copyright
© 2016 Elsevier Ltd. All rights reserved.
