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ORIGINAL ARTICLE
Year : 2022  |  Volume : 5  |  Issue : 3  |  Page : 145-150

Early outcomes of ultra-congruent insert in cruciate-retaining total knee arthroplasty: A prospective study


1 Department of Orthopaedics, Shri Guru Ram Das Institute of Medical Sciences and Research, Amritsar; Department of Orthopaedics, Maharishi Markandeshwar, Medical College and Hospital, Solan, Himachal Pradesh, India
2 Department of Orthopaedics, Shri Guru Ram Das Institute of Medical Sciences and Research, Amritsar; Department of Radiodiagnosis, All India Institute of Medical Sciences, Patiala, Punjab, India
3 Department of Orthopaedics, Shri Guru Ram Das Institute of Medical Sciences and Research, Amritsar; Department of Orthopaedics, Government Medical College, Patiala, Punjab, India

Correspondence Address:
Punit Tiwari
Department of Orthopaedics, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jodp.jodp_13_22

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Introduction: The exponents of cruciate-retaining (CR) total knee arthroplasty (TKA) assert that the retention of posterior cruciate ligament (PCL) preserves more normal knee kinematics, femoral rollback on the tibia during flexion, greater stabilization of the prosthesis, and improved position sense as compared to PCL resection TKA. However, one has to shift to the posterior stabilized (PS) femoral component with box and accompanying cam postpolyethylene, especially in cases where PCL is too attenuated to be functional or too tight predisposing to accelerated polyethylene wear. To minimize both the cam mechanism polyethylene wear and the bone sacrifice due to the intercondylar box cut, the ultra-congruent (UC) inserts have been developed that are characterized by a high anterior wall and a deep-dished plate, promising good stability without cam mechanism. Materials and Methods: We did a prospective study to clinically evaluate the short-term results of the patients who underwent TKA using cemented posterior CR implants and UC inserts. PCL was required to be released either partially or completely in all the study patients. Thirty patients were evaluated preoperatively and postoperatively after 12 months with the new Knee Society Knee Scoring System (2011) and the findings were statistically analyzed. Results: There was a statistically significant postoperative improvement in flexion (from mean of 87.69° to 111.53°, P = 0.000), objective knee indicators (33.53 ± 8.51–70.84 ± 4.91, P = 0.000), patient satisfaction scores (7.48 ± 2.12–21.53 ± 4.26, P = 0.000), and the functional activities score (32.53 ± 5.12–69.02 ± 6.36, P = 0.000). We did not note any disadvantage of CR TKA with UC insert and no patient underwent an early revision for instability. Conclusion: Using UC insert in CR TKA is a reliable procedure that has decreased the dependence on the PS designs.


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