Evaluation of Postoperative Range of Motion and Functional Outcomes after Cruciate-Retaining and Posterior-Stabilized High-Flexion Total Knee Arthroplasty
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Purpose: The purpose of this study was to compare postoperative range of motion and functional outcomes among patients who received high-flexion total knee arthroplasty using cruciate-retaining (CR-Flex) and posterior-stabilized (PS-Flex) type prostheses. Materials and Methods: Among 127 patients (186 knees) who underwent high-flexion total knee arthroplasty between 2005 and 2007, 92 knees were placed in the CR-Flex group, and 94 knees were placed in the PS-Flex group. After two years of postoperative follow-up, clinical and radiographic data were reviewed. Postoperative non-weight-bearing range of knee motion, angle of flexion contracture and functional outcomes based on the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) functional sub-scale were assessed and compared between the two groups. Results: After the 2-year postoperative period, the mean range of motion was 131° in the CR-Flex group and 133° in the PS-Flex group. There were no significant differences in postoperative range of motion between the two groups. Only age at operation and preoperative range of motion were significantly associated with postoperative range of motion after high-flexion total knee arthroplasty. Postoperative functional outcomes based on the WOMAC functional sub-scale were slightly better in the CR-Flex group (9.2±9.1 points) than in the PS-Flex group (11.9±9.6 points); however, this difference was not statistically significant (p=non-significant). Conclusion: The retention or substitution of the posterior cruciate ligament does not affect postoperative range of motion (ROM) or functional outcomes, according to 2 years of postoperative follow-up of high-flexion total knee arthroplasty.
Abstract
Purpose: The purpose of this study was to compare postoperative range of motion and functional outcomes among patients who received high-flexion total knee arthroplasty using cruciate-retaining (CR-Flex) and posterior-stabilized (PS-Flex) type prostheses. Materials and Methods: Among 127 patients (186 knees) who underwent high-flexion total knee arthroplasty between 2005 and 2007, 92 knees were placed in the CR-Flex group, and 94 knees were placed in the PS-Flex group. After two years of postoperative follow-up, clinical and radiographic data were reviewed. Postoperative non-weight-bearing range of knee motion, angle of flexion contracture and functional outcomes based on the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) functional sub-scale were assessed and compared between the two groups. Results: After the 2-year postoperative period, the mean range of motion was 131° in the CR-Flex group and 133° in the PS-Flex group. There were no significant differences in postoperative range of motion between the two groups. Only age at operation and preoperative range of motion were significantly associated with postoperative range of motion after high-flexion total knee arthroplasty. Postoperative functional outcomes based on the WOMAC functional sub-scale were slightly better in the CR-Flex group (9.2±9.1 points) than in the PS-Flex group (11.9±9.6 points); however, this difference was not statistically significant (p=non-significant). Conclusion: The retention or substitution of the posterior cruciate ligament does not affect postoperative range of motion (ROM) or functional outcomes, according to 2 years of postoperative follow-up of high-flexion total knee arthroplasty.
참고문헌 (32)
- Kurosaka M, "Maximizing flexion after total knee arthroplasty: the need and the pitfalls", J Arthroplasty, 17(4 Suppl 1), pp.59~62 (2002)
- Harvey IA, "Factors affecting the range of movement of total knee arthroplasty", J Bone Joint Surg Br, 75, pp.950~955 (1993)
- Schurman DJ, "Prediction of postoperative knee flexion in Insall-Burstein II total knee arthroplasty", Clin Orthop Relat Res, pp.175~184 (1998)
- Ritter MA, "Predicting range of motion after total knee arthroplasty. Clustering, log-linear regression, and regression tree analysis", J Bone Joint Surg Am, 85(A), pp.1278~1285 (2003)
- Sharma A, "High-flexion TKA designs: what are their in vivo contact mechanics?", Clin Orthop Relat Res, 464, pp.117~126 (2007)
- Seon JK, "Comparisons of kinematics and range of motion in high-flexion total knee arthroplasty: cruciate retaining vs. substituting designs", Knee Surg Sports Traumatol Arthrosc, 19, pp.2016~2022 (2011)
- Cates HE, "In vivo comparison of knee kinematics for subjects having either a posterior stabilized or cruciate retaining high-flexion total knee arthroplasty", J Arthroplasty, 23, pp.1057~1067 (2008)
- 김준식, "Functional Outcome and Range of Motion of High-Flexion Posterior Cruciate-Retaining and High-Flexion Posterior Cruciate-Substituting Total Knee Prostheses A Prospective, Randomized Study", JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 91A, pp.753~760, American Association of Orthopaedic Surgeons
- Insall JN, "Rationale of the Knee Society clinical rating system", Clin Orthop Relat Res, pp.13~14 (1989)
- Insall JN, "A comparison of four models of total knee-replacement prostheses", J Bone Joint Surg Am, 58, pp.754~765 (1976)
- Bellamy N, "Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee", J Rheumatol, 15, pp.1833~1840 (1988)
- Ewald FC, "The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system", Clin Orthop Relat Res, pp.9~12 (1989)
- Figgie HE 3rd, "The influence of tibial-patellofemoral location on function of the knee in patients with the posterior stabilized condylar knee prosthesis", J Bone Joint Surg Am, 68, pp.1035~1040 (1986)
- Becker MW, "Bilateral total knee arthroplasty. One cruciate retaining and one cruciate substituting", Clin Orthop Relat Res, pp.122~124 (1991)
- Dorr LD, "Functional comparison of posterior cruciate-retained versus cruciate-sacrificed total knee arthroplasty", Clin Orthop Relat Res, pp.36~43 (1988)
- Banks SA, "Accurate measurement of three-dimensional knee replacement kinematics using single-plane fluoroscopy", IEEE Trans Biomed Eng, 43, pp.638~649 (1996)
- Dennis DA, "In vivo knee kinematics derived using an inverse perspective technique", Clin Orthop Relat Res, pp.107~117 (1996)
- Banks SA, "In vivo kinematics of cruciate-retaining and -substituting knee arthroplasties", J Arthroplasty, 12, pp.297~304 (1997)
- Dennis DA, "In vivo anteroposterior femorotibial translation of total knee arthroplasty : a multicenter analysis", Clin Orthop Relat Res, pp.47~57 (1998)
- Haas BD, "Kinematic comparison of posterior cruciate sacrifice versus substitution in a mobile bearing total knee arthroplasty", J Arthroplasty, 17, pp.685~692 (2002)
- Dennis DA, "Multicenter determination of in vivo kinematics after total knee arthroplasty", Clin Orthop Relat Res, pp.37~57 (2003)
- Insall JN., "Presidential address to The Knee Society. Choices and compromises in total knee arthroplasty", Clin Orthop Relat Res, pp.43~48 (1988)
- Scott RD, "Twelve years’ experience with posterior cruciate-retaining total knee arthroplasty", Clin Orthop Relat Res, pp.100~107 (1986)
- Maloney WJ, "Total condylar versus posterior stabilized total condylar designs", Clin Orthop Relat Res, pp.147~152 (1992)
- Conditt MA, "The PCL significantly affects the functional outcome of total knee arthroplasty", J Arthroplasty, 19(7 Suppl 2), pp.107~112 (2004)
- Insall JN, "The total condylar knee prosthesis in gonarthrosis. A five to nine-year follow-up of the first one hundred consecutive replacements", J Bone Joint Surg Am, 65, pp.619~628 (1983)
- Hirsch HS, "The posterior cruciate ligament in total knee surgery. Save, sacrifice, or substitute?", Clin Orthop Relat Res, pp.64~68 (1994)
- Bertin KC, "In vivo determination of posterior femoral rollback for subjects having a NexGen posterior cruciate-retaining total knee arthroplasty", J Arthroplasty, 17, pp.1040~1048 (2002)
- Tanzer M, "Posterior-stabilized versus cruciate-retaining total knee arthroplasty: balancing the gap", J Arthroplasty, 17, pp.813~819 (2002)
- Fuchs S, "Clinical and functional comparison of uni- and bicondylar sledge prostheses", Knee Surg Sports Traumatol Arthrosc, 13, pp.197~202 (2005)
- Mihalko WM, "Mechanoreceptors found in a posterior cruciate ligament from a well-functioning total knee arthroplasty retrieval", J Arthroplasty, 26, pp.504~ (2011)
- Dennis DA, "Range of motion after total knee arthroplasty: the effect of implant design and weight-bearing conditions", J Arthroplasty, 13, pp.748~752 (1998)