EUROP total knee prosthesis with or without posterior cruciate ligament retention? Comparative study at mid-term follow-up

Abstract

IntroductionThe aim of the present study was to compare mid-term clinical and functional results of two fixed-bearing EUROP total knee arthroplasties (TKA) with the same design, one in which the posterior cruciate ligament was retained (CR) and the other with posterior-stabilization (PS). HypothesisMid-term results are similar. Materials and methodsIn this prospective, single centre, comparative study, 104 patients (mean age 76) received 114 cemented fixed-bearing posterior cruciate-retaining or posterior-stabilized EUROP TKA. Only patients in whom the medial pivot and ligaments were intact received a CR prosthesis. The final decision to retain or not the posterior cruciate ligament was made if the flexion gap was well balanced above 90°. Clinical evaluation was performed using the International Knee Society (IKS) score at a mean follow-up of 54months. ResultsThe preoperative IKS function score improved from 30 points in both groups, to 75 points in the CR group and to 65 points in the PS group postoperatively. The preoperative IKS knee score improved from 29 and 25 points in the CR and PS groups, respectively, to 87 points in both groups postoperatively. There was no significant difference in the pre- or postoperative scores between the two groups. Four prostheses underwent surgical revision, three CR and one PS. With revision for any reason as the end point, seven-year overall implant survival was 94.8% in the CR group and 97.5% in the PS group. There was no significant difference between the CR and PS groups. DiscussionWhen the indications were followed, our study shows similar mid-term results for both types of TKA. Level of evidenceLevel IV, prospective study.