KMID : 1207720240160010066
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Clinics in Orthopedic Surgery 2024 Volume.16 No. 1 p.66 ~ p.72
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Comparing Outcomes of Bicruciate-Stabilized and Cruciate-Retaining Total Knee Arthroplasty
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Lorena Hernandez
Ittai Shichman Thomas H. Christensen Joshua C. Rozell Morteza Meftah Ran Schwarzkopf
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Abstract
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Background: Bicruciate-stabilized (BCS) total knee arthroplasty (TKA) aims to restore normal kinematics by replicating the function of both cruciate ligaments. Conventional cruciate-retaining (CR) design in TKA has shown previous clinical success with lower complication rates. This study compared the patient-reported outcomes between the BCS and CR TKA designs.
Methods: This retrospective study examined patients who underwent primary TKA using a CR or a BCS implant. Patient demographics, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR), and Forgotten Joint Score (FJS) were compared between two cohorts. Patient-reported outcome measures were analyzed using independent samples t -tests.
Results: There were no significant preoperative demographic differences between groups. The CR cohort (n = 756) had significantly higher average KOOS, JR Scores compared to the BCS cohort (n = 652) at 3 months (59.7 ¡¾ 3.8 vs. 53.0 ¡¾ 3.9, p < 0.001) and 2 years (62.6 ¡¾ 8.0 vs. 53.8 ¡¾ 6.7, p = 0.001) after TKA. Within the cohort, KOOS, JR delta differences were not significant for CR when comparing patient scores 3 months to 1 year after surgery. Meanwhile, the BCS patients did show significant delta improvement (4.1 ¡¾ 1.9, p = 0.030) when compared 3 months to 1 year after surgery. One year postoperatively, the BCS cohort (n = 134) showed a significantly higher average FJS score (49.5 ¡¾ 31.4, vs. 36.8 ¡¾ 28.5, p = 0.028) than the CR cohort (n = 203). Both cohorts displayed a significant difference in delta improvements within their respective cohort when measuring FJS from 3 months to 1 year, 2 years, and 3 years after surgery.
Conclusions: The CR cohort performed better on average, compared to the BCS cohort in measures of KOOS, JR scores at the 2-year follow-up. The BCS cohort performed marginally better regarding FJS only at 1-year follow-up.
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KEYWORD
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Total knee arthroplasty, Knee prostheses, Patient reported outcomes
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