No differences in clinical outcomes or isokinetic performance between cruciate-substituting ultra-congruent and posterio
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KNEE
No differences in clinical outcomes or isokinetic performance between cruciate‑substituting ultra‑congruent and posterior stabilized total knee arthroplasties: a randomized controlled trial Sefa Akti1 · Dilek Karakus2 · Erdem Aras Sezgin1 · Deniz Cankaya1 Received: 8 June 2020 / Accepted: 8 September 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose Whether ultra-congruent (UC) or posterior cruciate ligament-stabilized (PS) inserts should be used in posterior cruciate ligament (PCL)-sacrificing total knee arthroplasty (TKA) remains debatable. Therefore, the aim of this prospective randomized controlled study was to compare the isokinetic performance and clinical outcomes of these inserts in PCLsacrificing TKA. Methods Sixty-six patients diagnosed with primary knee osteoarthritis were randomly assigned to either the UC or the PS group. There were no significant differences between the groups in terms of age, body mass index or sex. The Knee Society score (KSS) and isokinetic performance results for each patient were recorded preoperatively and at 3, 6 and 12 months postoperatively. The physiatrist that performed the isokinetic tests and the patients were blinded to the study groups. Results There were no significant differences between the groups in terms of the preoperative KSS or isokinetic performance. Gradual improvement in the KSS was observed in both groups, but no significant differences were detected between the groups during the whole follow-up period. The UC and PS groups exhibited similar peak extension and flexion torque values normalized to body weight at 3, 6 and 12 months postoperatively (p > 0.05). Conclusion The use of UC or PS inserts in TKA did not affect the clinical outcomes or isokinetic performance.The clinical relevance of this study is that the potential differences in clinical outcomes and isokinetic performance between UC and PS inserts do not need to be considered when sacrificing the PCL in TKA. Level of evidence I. Keywords Ultra-congruent · Insert · Isokinetic · Total knee replacement · Posterior stabilized
Introduction Posterior cruciate ligament (PCL) retention versus sacrifice is one of the main topics related to total knee arthroplasty (TKA) that is debated, and which method is selected depends on the individual preference of the surgeon during the surgery [4]. The outcomes of PCL retention and sacrifice have been compared in many studies; however, the * Sefa Akti [email protected] 1
Department of Orthopaedic and Traumatology, Aksaray University Education and Research Hospital, Tacin Street, 68120 Aksaray, Turkey
Department of Physical Medicine and Rehabilition, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
2
superiority of one method over the other has not been demonstrated [14]. Most authors recommend sacrificing the PCL in cases of flexion contracture or PCL insufficiency [19]. Whenever a surgeon decides to sacrifice the PCL, another controversial question arises regarding the
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