Higher revision percentage in cruciate ligament sacrificing total knee prostheses

What is it about?

Based on the literature, there is no preference for the use of a total knee prosthesis that spares the posterior cruciate ligament (cruciate retaining) or sacrifices it (posterior stabilized). However, preference varies greatly among Dutch healthcare providers. This does not seem to depend on patient characteristics; 20 hospitals placed cruciate retaining knee prostheses with the vast majority, while 24 hospitals placed a posterior stabilized knee prosthesis in the majority of its cases. This study investigated the 8-year revision percentages of all 133,841 cemented fixed bearing primary cruciate retaining or posterior stabilized knee arthroplasties, placed for osteoarthritis in the period 2007-2016. A distinction has been made between men and women of different age categories. The degree of revision was also examined. Conclusion: Patients who received a primary cemented posterior stabilized knee prosthesis with a fixed bearing due to osteoarthritis have a greater risk of undergoing a major or minor revision within 8 years than patients who received a cruciate retaining knee prosthesis. This difference was particularly striking in younger men.

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Why is it important?

These results help both the surgeon and the patient in the complex process of preoperative decision-making.