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Three different cruciate-sacrificing TKA designs: minor intraoperative kinematic differences and negligible clinical differences

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The goal of this study was to compare three types of mobile-bearing posterior cruciate ligament (PCL)-sacrificing TKA. The hypothesis was that the three designs provide differences in flexion stability and femoral rollback and improved clinical score at 2-year follow-up.

Methods

Three groups of patients, divided according to implant design, were analysed retrospectively. All operations were guided by a non-image-based navigation system that recorded relative femoral and tibial positions in native and implanted knees during: passive range of motion and anterior drawer test at 90° flexion. WOMAC, KSS and SF36 scores were collected pre-operatively and at 2-year follow-up.

Results

There are no differences in kinematic or clinical performance of the three implants, except for the antero-posterior translation during stress test in flexion: only Cohort B had comparable pre- and post-operative laxity test values (p < 0.001). All three TKA designs allowed to maintain pre-operative tibial rotation pattern through all range of knee flexion. All clinical scores of the three patient cohorts were significantly improved post-operatively compared to the pre-operative values (p < 0.001). Moreover, we found no differences among post-operative results of the three designs.

Conclusion

Despite design variations, mobile-bearing PCL-sacrificing TKA reproduces femoral rollback and screw-home with little or no difference in clinical or functional scores at a follow-up of 2 years.

Level of evidence

III.

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Acknowledgments

The authors would like to thank Mo Saffarini for his assistance in the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy

    Stefano Zaffagnini, Ibrahim Akkawi, Tedi Marko, Danilo Bruni, Maria Pia Neri, Francesca Colle & Maurilio Marcacci

  2. Laboratorio di Biomeccanica e Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy

    Simone Bignozzi, Stefano Zaffagnini, Ibrahim Akkawi, Tedi Marko, Danilo Bruni, Maria Pia Neri & Maurilio Marcacci

  3. Laboratorio di NanoBiotecnologie (NaBi), Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy

    Francesca Colle & Maurilio Marcacci

  4. Scuola Superiore Sant’Anna, The Biorobotic Institute, Pisa, Italy

    Francesca Colle

Authors
  1. Simone Bignozzi
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  2. Stefano Zaffagnini
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  8. Maurilio Marcacci
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Correspondence to Simone Bignozzi.

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Bignozzi, S., Zaffagnini, S., Akkawi, I. et al. Three different cruciate-sacrificing TKA designs: minor intraoperative kinematic differences and negligible clinical differences. Knee Surg Sports Traumatol Arthrosc 22, 3113–3120 (2014). https://doi.org/10.1007/s00167-014-3200-5

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  • DOI: https://doi.org/10.1007/s00167-014-3200-5

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