Abstract :
Introduction: The role of the posterior cruciate ligament (PCL) in total knee arthroplasty (TKA) has been widely discussed in the orthopaedic literature. Theoretical and functional arguments and survivorship have all been used to support both its retention and its substitution. Moreover, with the advent of robotics and ever
evoluting kinematic surgical procedures, the results for the cruciate-retaining arthroplasties are found to be more variable than for the cruciate substituting arthroplasties. The present study is sought to investigate if there was a difference in the clinical outcome as measured by the commonly-used scoring systems which
includes (International Knee Society Score, Western Ontario McMasters Osteoarthritis (WOMAC) index and the SF- 36 health survey along with the radiological scores and outcomes of the two procedures in TKA.
Methodology and Results: We performed a prospective, randomized trial of 30 patients to compare the functional outcomes of a posterior-cruciate-ligament-retaining and posterior- cruciate-ligament substituting total knee arthroplasty. Statistical analysis was performed using the Student’s t-test and ANOVA test for multiple trials. At follow-up at 3 months, no statistically significant differences were found in the clinical outcome measurements for either design. The results of theWOMAC 35 score which were subdivided into pain, stiffness and function showed high scores for cruciate substituting groups for pain as compared to the cruciate retaining groups whereas, other parameters were same in both the groups. For other systems including SF-36 and knee society score the results did not seem to vary to a great extent statistically.
Conclusion: To conclude the present study found almost similar results for Cruciate ligament retaining
and substituting procedures in long term follow up at 3 months, with slightly better outcomes for Cruciate
ligament retaining groups at the earliest phases pre operatively and post operatively.
Keyword :
PCL, Total knee arthroplasty, WOMAC system, SF36 system, Knee society score, Posterior cruciate retention surgery, Posterior cruciate ligament substitution