Posterior Cruciate Retaining Total Knee Arthroplasty in Severe Deformed Knee

Abstract

Severe deformed knee is surgical challenging. Fully constrained knee prosthesis is the proper one. However various techniques and methods were advocated to address the problem. This study will show the results of PCL retaining knee prosthesis combining with various techniques.

Material and Method: A retrospective descriptive study of 6-12 years follows up of TKA in 28 severe deformed knees. The Knee Society Score and Roentgenographic Scoring System were used for monitoring the outcome.

Results: During July 1989 to October 2005, 28 knees were performed total knee replacement with PCL retaining prosthesis (Balansys Model). Age average was 65 years. Pre-operative Knee Society Score1 were 6 on pain, 15 on range of motion, 4 on stability and 7 on function. There were 12 knees could achieved TKA with only soft tissue released and balanced, 14 knees needed to fill the defect with bone graft, the other 2 knees used only positioning screw alone. The mean follow up time was 9.5±3.5 years. The knee score at last follow up were 35 on pain, 23 on range of motion, 24 on stability and 70 on functions. The total knee arthroplasty radiographic Knee Society Score was 0.5. There was significant clinical improved statistically.

Conclusion: Severe deformed knee can be treated effectively with PCL retaining prosthesis. Good alignment, stable knee and proper postoperative program are essential for the good outcome.