Abstract
We compared function in two groups of high demand patients who had undergone total knee arthroplasty (TKA), one group using a posterior cruciate sacrificing (PCS) prosthesis and the other a posterior cruciate retaining (PCR) prosthesis of similar design.
Patients were eligible for the study if surgery had been performed more than two years ago and they were under 65 years of age and had no coexisting morbidity that markedly decreased their physical activities. One surgeon operated on 28 patients in group A (20 TKAs), routinely retaining the posterior cruciate ligament (PCL). A second surgery operated on 19 patients in group B (25 TKAs) and routinely sacrificed the PCL. A mobile bearing prosthesis of similar design was used in each group. Patients were independently selected and assessed using a questionnaire specifically developed to assess higher levels of activity not usually assessed by other knee scores. Patients in the two groups were matched in terms of age, range of motion and follow-up
The gross activity score was 3.36 in group A and 3.12 in group B. The combined walking, running and stair-climbing score was in group A (7.68) than in group B (6.64). Patients in group B had decreased anterior knee pain and perceived their TKA closer to a normal knee (2.00 compared to 2.32).
We conclude that retaining the PCL in TKA results in better patient function without obvious complications.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at The Department of Orthopaedic Surgery, Medical School, University of Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193 South Africa
