|
Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 5,
671-674.
doi: 10.1302/0301-620X.85B5.13812 Copyright © 2003 by British Editorial Society of Bone and Joint Surgery Posterior cruciate ligament at total knee replacementESSENTIAL, BENEFICIAL OR A HINDRANCE?R. Straw, MRCE, Orthopaedic Registrar; S. Kulkarni, FRCS Orth, Orthopaedic Registrar; S. Attfield, MPhil CEng, MIMechE Research; and T. J. Wilton, MA, FRCS, Consultant Orthopaedic SurgeonDerbyshire Royal Infirmary, London Road, Derby DE1 2QY, UK. Correspondence should be sent to Mr T. J. Wilton at 22 Castle Hill, Belper, Derbyshire DE56 4EA, UK. We report the results of a prospective randomised trial which assessed the role of the posterior cruciate ligament (PCL) following total knee replacement (Genesis I; Smith and Nephew, Memphis, Tennessee). Over a four-year period, 211 patients underwent total knee replacement by the senior author (TJW). They were randomised at surgery to have the PCL either retained, excised or substituted with a posterior stabilised insert. If it was not possible to retain the ligament due to soft-tissue imbalance, it was released from its tibial insertion until suitable tension was obtained. This created a fourth group, those who were intended preoperatively to have the ligament retained, but in whom it was partially released as a result of findings at the time of surgery. All patients were evaluated using the Knee Society rating system (adapted from Insall). A total of 188 patients (212 knees) was available for follow-up at a mean of 3.5 years after surgery. Preoperatively, there was a varus deformity in 191 knees (90%) and a valgus deformity in 21 (10%). There were no statistical differences in the knee or function scores or the range of movement between the excised, retained and substituted groups. There were, however, significantly worse knee and function scores in the group in whom the PCL was released (p = 0.002). This article has been cited by other articles:
|
|
||||||||||||||||||||||||
