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Posterior Cruciate Ligament Retention versus Posterior Stabilization for Total Knee Arthroplasty: A Meta-Analysis.
PLoS One. 2016; 11(1):e0147865.Plos

Abstract

INTRODUCTION

Although being debated for many years, the superiority of posterior cruciate-retaining (CR) total knee arthroplasty (TKA) and posterior-stabilized (PS) TKA remains controversial. We compare the knee scores, post-operative knee range of motion (ROM), radiological outcomes about knee kinematic and complications between CR TKA and PS TKA.

METHODS

Literature published up to August 2015 was searched in PubMed, Embase and Cochrane databases, and meta-analysis was performed using the software, Review Manager version 5.3.

RESULTS

Totally 14 random control trials (RCTs) on this topic were included for the analysis, which showed that PS and CR TKA had no significant difference in Knee Society knee Score (KSS), pain score (KSPS), Hospital for Special Surgery score (HSS), kinematic characteristics including postoperative component alignment, tibial posterior slope and joint line, and complication rate. However, PS TKA is superior to CR TKA regarding post-operative knee range of motion (ROM) [Random Effect model (RE), Mean Difference (MD) = -7.07, 95% Confidential Interval (CI) -10.50 to -3.65, p<0.0001], improvement of ROM (Fixed Effect model (FE), MD = -5.66, 95% CI -10.79 to -0.53, p = 0.03) and femoral-tibial angle [FE, MD = 0.85, 95% CI 0.46 to 1.25, p<0.0001].

CONCLUSIONS

There are no clinically relevant differences between CR and PS TKA in terms of clinical, functional, radiological outcome, and complications, while PS TKA is superior to CR TKA in respects of ROM, while whether this superiority matters or not in clinical practice still needs further investigation and longer follow-up.

Authors+Show Affiliations

Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26824368

Citation

Jiang, Chao, et al. "Posterior Cruciate Ligament Retention Versus Posterior Stabilization for Total Knee Arthroplasty: a Meta-Analysis." PloS One, vol. 11, no. 1, 2016, pp. e0147865.
Jiang C, Liu Z, Wang Y, et al. Posterior Cruciate Ligament Retention versus Posterior Stabilization for Total Knee Arthroplasty: A Meta-Analysis. PLoS ONE. 2016;11(1):e0147865.
Jiang, C., Liu, Z., Wang, Y., Bian, Y., Feng, B., & Weng, X. (2016). Posterior Cruciate Ligament Retention versus Posterior Stabilization for Total Knee Arthroplasty: A Meta-Analysis. PloS One, 11(1), e0147865. https://doi.org/10.1371/journal.pone.0147865
Jiang C, et al. Posterior Cruciate Ligament Retention Versus Posterior Stabilization for Total Knee Arthroplasty: a Meta-Analysis. PLoS ONE. 2016;11(1):e0147865. PubMed PMID: 26824368.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Posterior Cruciate Ligament Retention versus Posterior Stabilization for Total Knee Arthroplasty: A Meta-Analysis. AU - Jiang,Chao, AU - Liu,Zhenlei, AU - Wang,Ying, AU - Bian,Yanyan, AU - Feng,Bin, AU - Weng,Xisheng, Y1 - 2016/01/29/ PY - 2015/10/20/received PY - 2016/01/08/accepted PY - 2016/1/30/entrez PY - 2016/1/30/pubmed PY - 2016/7/9/medline SP - e0147865 EP - e0147865 JF - PloS one JO - PLoS ONE VL - 11 IS - 1 N2 - INTRODUCTION: Although being debated for many years, the superiority of posterior cruciate-retaining (CR) total knee arthroplasty (TKA) and posterior-stabilized (PS) TKA remains controversial. We compare the knee scores, post-operative knee range of motion (ROM), radiological outcomes about knee kinematic and complications between CR TKA and PS TKA. METHODS: Literature published up to August 2015 was searched in PubMed, Embase and Cochrane databases, and meta-analysis was performed using the software, Review Manager version 5.3. RESULTS: Totally 14 random control trials (RCTs) on this topic were included for the analysis, which showed that PS and CR TKA had no significant difference in Knee Society knee Score (KSS), pain score (KSPS), Hospital for Special Surgery score (HSS), kinematic characteristics including postoperative component alignment, tibial posterior slope and joint line, and complication rate. However, PS TKA is superior to CR TKA regarding post-operative knee range of motion (ROM) [Random Effect model (RE), Mean Difference (MD) = -7.07, 95% Confidential Interval (CI) -10.50 to -3.65, p<0.0001], improvement of ROM (Fixed Effect model (FE), MD = -5.66, 95% CI -10.79 to -0.53, p = 0.03) and femoral-tibial angle [FE, MD = 0.85, 95% CI 0.46 to 1.25, p<0.0001]. CONCLUSIONS: There are no clinically relevant differences between CR and PS TKA in terms of clinical, functional, radiological outcome, and complications, while PS TKA is superior to CR TKA in respects of ROM, while whether this superiority matters or not in clinical practice still needs further investigation and longer follow-up. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/26824368/Posterior_Cruciate_Ligament_Retention_versus_Posterior_Stabilization_for_Total_Knee_Arthroplasty:_A_Meta_Analysis_ L2 - http://dx.plos.org/10.1371/journal.pone.0147865 DB - PRIME DP - Unbound Medicine ER -