Comparison of Cruciate Retaining and Posterior Stabilized Total Knee Arthroplasty
Condition: Osteoarthritis, Knee; Arthropathy of Knee Joint
MeSH terms: Osteoarthritis, Knee
Study type: Interventional

Summary: 
      Several authors and large registries have suggested the potential for an increased risk of
      all-cause revision with the use of posterior cruciate-substitution (PS) total knee
      arthroplasty (TKA). The purpose of the current study was to compare posterior cruciate
      retaining (CR) and PS implants with respect to the functional and radiographic results,
      prevalence of osteolysis, revision rates and survivorship.
    

Detailed description: 
      The supremacy debate between posterior cruciate-retaining (CR) and posterior stabilized (PS)
      total knee arthroplasty (TKA) has now entered into the 4th decade. Multiple research studies
      have investigated CR and PS TKAs on the basis of kinematic, clinical, radiographic, and
      survivorship analysis. Despite arguments in favor of CR or PS TKA designs, several short or
      mid-term studies have shown no difference in functional outcomes between these two designs.
      Considering the fact that CR and PS TKA fare equally at short-term and mid-term, the decision
      to select either design should depend on their long-term survivorship. There have been few
      long-term survivorship analysis that have directly compared CR and PS TKAs with aseptic
      revision for any reason as the end point.

      These long-term studies of CR and PS TKA have been done independently. A comparison of the
      results in the same patients eliminates the variability that is introduced by differences in
      gender, age, weight, comorbidity, bone quality, and activity level and allows for a
      meaningful comparison of the impact of fixation on the outcome of TKA. However, variability
      in terms of the preoperative severity of arthritis cannot be eliminated because of the design
      on both sides is rarely identical.

      The purpose of this study was to identify differences in implant survivorship between CR and
      PS TKAs in patients with osteoarthritis who were younger than 65 years of age and CR implant
      in one knee and PS implant in the other.
    

Intervention name(s): Total knee replacement with cruciate retaining femoral component; Total knee replacement with cruciate substituting femoral component
Intervention type(s): Procedure; Procedure
Intervention description(s): To perform the total knee replacement, the knee joint is anatomically dissected, and thin portions of bone and cartilage is resected to accommodate a metallic implants. Implants are fixed to patients' bone with bone cements. Many designs for femoral component designs are available. In the present study, two types of implants, one CR(cruciate retaining), where the posterior cruciate ligaments are retained, and one PS(Posterior cruciate substituting), where the posterior cruciate ligaments are resected, will be compared. To make the comparison more reliable, the same kind of implants will be used, so that the major portions of femoral component design remains the same and the tibial component remains the same. Only the cruciate ligament parts are different. For this arm of intervention, CR knee will be used, so posterior cruciate will remain intact after the surgery and still function to aid in the knee stability.; To perform the total knee replacement, the knee joint is anatomically dissected, and thin portions of bone and cartilage is resected to accommodate metallic implants that has similar contours of a native knee. Implants are fixed to patients' bone with bone cements. This procedure will use the femoral component that sacrifice the posterior cruciate ligament and having a box area with a post, so that "cam-post" mechanism of implants can mimic the function of the posterior cruciate ligament. To make the comparison more reliable, the same kind of implants will be used, so that the major portions of femoral component remains the same. The tibial component will remain the same design. Therefore, only the cruciate ligament parts will be different.
Allocation: Randomized
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment