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PCL preservation or sacrifice does not influence clinical outcomes and survivorship at mid-term follow-up of a J-curve CR total knee replacement with a medial congruent liner and a functional coronal alignment

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

In recent years, increasing interest has arisen for medial pivoting TKA implants, designed to mimic the physiological knee kinematics, maximizing the contact area on the medial compartment of the knee, increasing anterior–posterior stability, and contributing to a ball-in-socket effect that allows the posterior cruciate sacrifice without a post-CAM mechanism. The medial congruent liner works with a J-curve cruciate-retaining (CR) femur without a real ball-in-socket design. The aim of this study was to evaluate the clinical outcomes and survival of these implants, with or without PCL sparing, at a medium follow-up.

Methods

Between October 2016 and October 2018, 165 TKRs were performed in 161 patients (69.2% females and 30.8% males) and prospectively followed. Mean follow-up was 72 ± 12 months. All surgeries were performed using an extramedullary device and the same prosthetic implant. Patients were matched in two groups: in 80 patients, the PCL was preserved; in 85 patients, the PCL was sacrificed with a reduction of the tibial slope.

Results

The OKS and KSS improved in both groups. The difference between the two groups at the final follow-up was not statistically significant. Good-to-excellent clinical results according to the KSS were achieved in 93% of the knees in the PCP group and in 95% in the PCS group. At final follow-up, the Forgotten Joint Score (FJS) was 73.6 in the PCP group and 74.1 in the PCS group with no statistical difference between the two groups (P > 0.05).

Conclusions

TKA with a medially congruent insert, showed promising results at mid-term follow-up, PCL preservation or sacrifice did not affect the clinical outcomes and survival. Further follow-up will be needed to evaluate these results at long term.

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Authors and Affiliations

  1. Sezione di Chirurgia Protesica ad Indirizzo Robotico, Unità di Traumatologia dello Sport, UOC Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati, 57, 25124, Brescia, Italy

    Stefano Marco Paolo Rossi, Rudy Sangaletti, Alice Montagna & Francesco Benazzo

  2. Clinica Ortopedica e Traumatologica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Eugenio Jannelli & Alice Montagna

  3. U.O. Ortopedia e Traumatologia, Humanitas Mater Domini, Castellanza, Italy

    Davide Bova

  4. IUSS, Istituto Universitario di Studi Superiori, Pavia, Italy

    Francesco Benazzo

Authors
  1. Stefano Marco Paolo Rossi
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  2. Rudy Sangaletti
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  3. Eugenio Jannelli
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  4. Davide Bova
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  5. Alice Montagna
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  6. Francesco Benazzo
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Contributions

SMPR designed and was responsible for the manuscript, RS contributed to write the manuscript and finalize the statistical section, EJ, AM, and DB were responsible for the clinical follow-up of the patients, and SMPR and FB revised the manuscript.

Corresponding author

Correspondence to Stefano Marco Paolo Rossi.

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Conflict of interest

FB declares a teaching contract with the manufacturer (Zimmer Biomet). No conflict of interest to be declared by any of the authors for the current study. FB is consultant for Zimmer Biomet and LimaCorporate; Grants from LimaCorporate; Royalties from Zimmer Biomet and LimaCorporate. The other authors have no disclosures.

Ethical approval

This study obtained IRB approval (No. 2015001968), and written consent was obtained from all patients. The study was approved by the local ethical committee with IRB approval No. 2015001968.

Informed consent

Written consent was obtained from all patients.

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Rossi, S.M.P., Sangaletti, R., Jannelli, E. et al. PCL preservation or sacrifice does not influence clinical outcomes and survivorship at mid-term follow-up of a J-curve CR total knee replacement with a medial congruent liner and a functional coronal alignment. Arch Orthop Trauma Surg 144, 307–313 (2024). https://doi.org/10.1007/s00402-023-05033-3

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