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Posterior stabilised total knee arthroplasty is associated with improved post-operative knee specific function, health related quality of life and greater satisfaction when compared to cruciate retaining protheses

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To assess whether there were differences in knee specific function, health related quality of life (HRQoL), and satisfaction between patients with a cruciate retaining (CR) or a posterior stabilised (PS) total knee arthroplasty (TKA) at 1 and 2 years postoperatively.

Methods

A retrospective review of TKA (CR and PS) patients from a prospectively collected arthroplasty database. Patient demographics, body mass index and ASA grade, Oxford knee score (OKS) and EuroQol 5-dimension (EQ-5D) 3-level, which was used to assess HRQoL, were collected preoperatively and 1 year and 2 years postoperatively. Regression was used to adjust for confounding factors.

Results

The sample included 3122 TKA, of which 1009 (32.3%) were CR and 2112 (67.7%) were PS. The PS group were more likely to be female (odd ratio (OR) 1.26, p = 0.003) and undergo resurfacing of the patella (OR 6.63, p < 0.001). There was a significantly greater improvement in the 1 year OKS in the PS group (mean difference (MD) 0.9, p = 0.016). The PS TKA was independently associated with a greater 1 year (MD 1.1, 95% CI 0.4 to 1.9, p = 0.001) and 2 years (MD 0.8, p = 0.037) post-operative improvements in OKS. PS TKA was also independently associated with a greater 1 year (MD 0.021, p = 0.024) and 2 years (MD 0.022, p = 0.025) post-operative and change in EQ-5D utility compared to the CR group. The PS group was more likely to be satisfied with their outcome at 1 year (OR 1.75, p < 0.001) and at 2 years (OR 1.38, p = 0.001) when adjusting for confounders.

Conclusion

PS TKA was associated with a better knee specific function and HRQoL when compared to CR, but the clinical significance of this is not clear. However, the PS group was more likely to be satisfied with their outcome compared to the CR group.

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Funding

The authors have no relevant financial or non-financial interests to disclose in relation to this article.

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Authors and Affiliations

  1. Southwest London Orthopaedic Elective Centre, Epsom General Hospital, Epsom, Surrey, KT18 7EG, UK

    N. D. Clement, J. Edwards, I. Afzal, S. Jones, S. Radha & D. Kader

  2. Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK

    N. D. Clement

  3. St Georges University Hospitals NHS Foundation Trust, London, UK

    S. Abbott

Authors
  1. N. D. Clement
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  2. J. Edwards
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  3. I. Afzal
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  4. S. Abbott
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  5. S. Jones
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  6. S. Radha
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  7. D. Kader
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Correspondence to J. Edwards.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was classed as a service evaluation without the need for formal ethical approval. The project was registered with the institution’s audit department and was conducted in accordance with the Declaration of Helsinki and the guidelines for good clinical practice [11]. There was no funding of this study or conflict of interests to report.

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Clement, N.D., Edwards, J., Afzal, I. et al. Posterior stabilised total knee arthroplasty is associated with improved post-operative knee specific function, health related quality of life and greater satisfaction when compared to cruciate retaining protheses. Eur J Orthop Surg Traumatol 33, 3411–3418 (2023). https://doi.org/10.1007/s00590-023-03565-3

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  • DOI: https://doi.org/10.1007/s00590-023-03565-3

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