Clin Orthop Surg.  2016 Dec;8(4):379-385. 10.4055/cios.2016.8.4.379.

Does Cruciate-Retaining Total Knee Arthroplasty Show Better Quadriceps Recovery than Posterior-Stabilized Total Knee Arthroplasty? - Objective Measurement with a Dynamometer in 102 Knees

• Cho KY
• Kim KI
• Song SJ
• Bae DK

• KMID: 2412319
• DOI: http://doi.org/10.4055/cios.2016.8.4.379

Abstract

BACKGROUND
Cruciate-retaining (CR) prostheses have been considered to produce more physiologic femoral rollback, provide better proprioception, and result in better quadriceps recovery than posterior-stabilized (PS) prostheses after total knee arthroplasty (TKA). However, there are very few studies demonstrating these benefits in an objective manner. We investigated whether CR-TKA could result in (1) better quadriceps recovery; (2) a greater proportion of patients with beyond the preoperative level of recovery; and (3) better clinical outcomes than PS-TKA.
METHODS
This was a prospective non-randomized comparative study on the results of CR-TKA and PS-TKA. CR prostheses were used in 51 knees and PS prostheses in 51 knees. Quadriceps force was measured with a dynamometer preoperatively and at postoperative 6 weeks, 3 months, and 6 months consecutively. The Knee Society score (KSS) and range of motion (ROM) were also evaluated.
RESULTS
There were no differences between two groups in terms of the objective quadriceps force during the follow-up period. The proportion of patients with beyond the preoperative level of recovery was similar between groups. Moreover, the KSS and ROM were not significantly different between two groups.
CONCLUSIONS
CR-TKA did not result in better quadriceps recovery than PS-TKA during the 6-month follow-up. In other words, PS-TKA could lead to comparable quadriceps recovery despite greater preoperative weaknesses such as more restricted ROM and more severe degenerative changes of the knee.

Keyword

Total knee arthroplasty; Muscle strength dynamometer; Muscle strength; Quadriceps muscle

MeSH Terms

Aged
Arthroplasty, Replacement, Knee/*methods/*statistics & numerical data
Humans
Middle Aged
Muscle Strength/physiology
Muscle Strength Dynamometer
Posterior Cruciate Ligament/*surgery
Prospective Studies
Quadriceps Muscle/*surgery
Range of Motion, Articular/physiology

Figure

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  Fig. 1 Bar graph showing the proportion of patients with beyond the preoperative level of quadriceps force. CR: cruciate-retaining, PS: posterior-stabilized.

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