J Korean Knee Soc.  2003 Dec;15(2):151-158.

Results of a Mobile Bearing Total Knee Replacement: Comparison of Retention and Sacrifice of the Posterior Cruciate Ligament

• Jung YB
• Kim JS
• Lee EY
• Jung HJ

Abstract

PURPOSE: The purpose of this study was to compare the results of posterior cruciate ligament retention and sacrificed total knee arthroplasties with mobile bearing design. MATERIALS AND METHODS: Between January 1992 and October 1997, the study consisted of two types of low contact stress(LCS) implants: a meniscal bearing implant(Group I) that retained the posterior crucaiate ligament(n=31), and a rotating platform implant(Group II) requiring sacrifice of this ligament(n=25). All patients were evaluated with pre-and postoperative range of motion and HSS(Hospital for Special Surgery)knee rating system and radiographic analysis at least five years following the knee replacement. RESULTS: The average active range of knee motion was 4 degrees-113 degrees (Group I), 5 degrees-109 degrees (Group II) preoperatively and 0 degrees-127 degrees (Group I), 0 degrees-118 degrees (Group II) at the final follow-up evaluation. The average HSS score was 61.7(Group I), 56.0(Group II) preoperatively and 90.1(Group I), 88.2(Group II) at the final follow-up evaluation. In group I, one patellar revision for patellar polyethylene breakage and one meniscal bearing change for medial meniscal bearing wear had been performed. In group II, one revision for infection and one rotating platform change had been performed for posterior instability during flexion. we had no dislocation of mobile bearing prosthesis, but 2 cases was required reoperation because of one traumatic periprosthetic fracture(Group 1) and one post. instability(Group 2). There was no significant progressive periprosthetic osteolysis on last follow-up radiographs in both groups. CONCLUSION: After five to ten years of follow-up, we found no signigicant difference between group I and II. However, it might be that subjective symptom is excellent in group I and surgical technique remains an important element of success with mobile bearing implants regardless of posterior cruciate ligament.

Keyword

Knee; Total knee replacement; Mobile bearing; Meniscal bearing; Rotating platform