Methods From May 2018 to September 2019, 105 cases of total knee arthroplasty (TKA) with CR highly congruent rotating platform prosthesis were retrospectively analyzed. These differences are clinically not relevant. Implant design influences tibial post wear damage in posterior-stabilized knees. To Compare the Change in American Knee Society Knee Score From Pre-op to 2 Years Between Sigma RP and Sigma Fixed Treatment Groups in PCL Sacrificing Arm [ Time Frame: Change from pre-op to 2 years ] American Knee Society (AKS) knee score is a 0-100 point score (where 100 indicates excellent knee condition) that evaluates the affected knee. This is often referred to as a cruciate sacrificing (CS) technique. What is the best knee replacement prosthesis? In 1991 Dr. A. Seth Greenwald did a study showing that if the strength of the PCL is 350 pounds, then the ultracongruent design is above that. Perioperative considerations for Total Knee Replacement Rehabilitation. Gender Solutions Natural-Knee Flex— Different design for men and women, allowing for PCL-retaining and PCL-sacrificing solutions. Dr. Rosenberg has been implanting press-fit, CR implants for over 25 years in athletic patients. PCL-sacrificing TKA and 15 had a PCL-retaining TKA. Arguments for Sacrificing the Posterior Cruciate Ligament in Total Knee Arthroplasty. J Bone Joint Surg Br 2003;85:389-92. Advocates for PCL-sacrificing total knee arthroplasty generally cite three possible advantages: (1) it facilitates correction of deformity, (2) it enhances range of passive motion, and (3) it decreases stress at the bone-implant interface. Participant will undergo total knee replacement performed via anterior parapatellar approach with either Posterior Cruciate Ligament sacrificing or retaining implant Diagnostic Test: CT scan CT scans of the affected knee joint before and after the surgical procedure Patients typically have to undergo revision surgery to replace the old knee replacement system every 20 years or so depending on the implant. The type of knee prosthesis (PCL-retaining or PCL-sacrificing) is an important factor that should be considered in evaluating the relationship between PTS and TKA outcomes. A critical factor in PCL-sparing (posterior cruciate ligament) TKA is the proper tensioning of the PCL. Zimmer Gender Solutions NexGen High-Flex Knee —Two different designs said to better match the size and shape of female and male joint anatomy. Component design, fixation method, operative technique (osteotomy, extensor mechanism technique), bone quality will all affect perioperative rehabilitation. Amongst the several factors affecting the kinematics, variations in surface geometry and the retention or sacrificing the posterior cruciate ligament is considered especially important. If the preoperative mechanical axis angle is over 7.7° varus, extensive release of medial soft tissue during PCL sacrificing TKA may lead to greater increases in medial flexion gaps than cruciate retaining TKA. If the PCL is too loose, posterior laxity makes participation in sports difficult. BACKGROUND In cruciate retaining total knee arthroplasty (TKA), a partial avulsion of PCL may occur when en-bloc tibial osteotomy is performed. We sought to determine if there was a difference in range of motion (ROM) after TKA between patients with PCL sacrifice versus PCL retention when using a highly congruent polyethylene insert. These are posterior cruciate ligament retaining (CR) and posterior cruciate ligament sacrificing (PS). The Journey II XR knee is the only type of knee commercially available in the United States that preserves both of these main stabilizing ligaments. DAA Cadaveric Session with Dr. Garrison. Chapter 110 Posterior Cruciate Sacrificing Total Knee Arthroplasty Aaron A. Hofmann, Jeremy McCandless Debate continues regarding the posterior cruciate ligament (PCL) in total knee arthroplasty (TKA). Gender Solutions Natural-Knee Flex— Different design for men and women, allowing for PCL-retaining and PCL-sacrificing solutions. d) osteonecrosis of the knee Spontaneous osteonecrosis of the knee (SONK) is not an indication for a hinged knee replacement. Total knee arthroplasty (TKA), a surgery that replaces a painfully damaged or diseased knee joint with a prosthesis, was performed in 267,000 patients in the year 2000 alone. Studies have reported that the influence of PTS on the ROM was notable in PCL-retaining TKA, whereas insignificant in PCL-sacrificing Reference: Miller sixth edition, P –403. An under 13 Maruyama S, Yoshiya S, Matsui N, Kuroda R, Kurosaka M. Functional comparison of posterior cruciate retaining versus posterior stabilized tota l knee arthroplasty. Total knee arthroplasty (TKA) is one of the most widely performed joint replacement operations, and seems to have overtaken total hip replacement in terms of volumes of procedures performed. Usually, full knee replacements involve sacrificing the Anterior Cruciate Ligament (ACL) and then optionally sacrificing the Posterior Cruciate Ligament (PCL). This chapter covers PCL-sacrificing (CS) TKA and therefore general aspects of total knee arthroplasty are discussed elsewhere. Similarly, in cases with over 10.4° varus, more significant increases in medial extension gap are likely after PCL sacrificing TKA. A total knee replacement (TKR) is usually done as the surgical treatment option for advancedosteoarthritis of the knee joint.During the surgery, the knee joint is replaced with artificial material. Two statistically significant differences were found; range of motion was 2.4 ° higher in the posterior cruciate ligament sacrificing group, however results were heterogeneous; and the mean functional Knee Society Score was 2.3 points higher in the posterior cruciate ligament sacrificing group. PCL sacrifice allows for easier correction of deformity, a better range of motion, and predictable kinematics. Research shows that surgeons utilizing PKA for at least 20% of their annual knee replacements experienced a significant decrease in their revision rate. This procedure requires certain implant design considerations in order to provide the resistance for translation that is typically provided by either the PCL in a CR knee or the cam and spine in a PS knee. Ten were men and 18 were women, with a mean age of 69. MCL deficiency is not treated with PCL sacrificing knee as this needs a more constrained hinge replacement. Following the bone resections, a PCL-substituting trial implant is placed. Two hundred nine patients underwent primary TKA. At full extension, 30 degrees of flexion, and 90 degrees of flexion, the knee is found to be tight laterally and loose medially. The PFC Sigma Total Knee System (Figure-1) was further advanced by the addition of a mobile-bearing rotating platform in the mid-1990’s by Dr.Thornhill and Dr.Scott.7 In this design, a polished chrome-cobalt tray accepts highly conforming, PCL-preserving, -sacrificing, or -substituting tibial inserts that are The study compared postoperative range of motion (ROM) and functional outcome of total knee arthroplasty (TKA) with a posterior cruciate ligament (PCL)-substituting knee prosthesis compared with an ultracongruent PCL-sacrificing design. sacrificing (CS) procedure in which the PCL is released but is not replaced by a cam and spine. Background: There is continued debate regarding retention versus sacrificing of the posterior cruciate ligament (PCL) in total knee arthroplasty (TKA). Indications for use include rheumatoid arthritis; post-traumaticarthritis, osteoarthritis or degenerative arthritis; failedosteotomies or unicompartmental replacement.