The Journal of Practical Medicine >

2024 , Vol. 40 >Issue 9: 1251 - 1256

DOI: https://doi.org/10.3969/j.issn.1006-5725.2024.09.012

Clinical Research

Comparison of the effects of CR and PS prostheses in the treatment of knee osteoarthritis

  • Shangzeng WANG ,
  • Bei ZHANG ,
  • Zhen WANG ,
  • Shang MA ,
  • Deyang RUANGZHANG ,
  • Zhiying YIN ,
  • Yunqi ZHU ,
  • Kunpeng HU ,
  • Shao CHENG
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  • Department of Orthopaedics，He′nan Province Hospital of Chinese Medicine （the Second Affiliated Hospital of He′nan University of TCM），Zhengzhou 450002，China
    *.He′nan University of Chinese Medicine，Zhengzhou 450046，China

Received date: 2023-11-27

  Online published: 2024-05-15

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Abstract

Objective To compare the effect of posterior cruciate ligament retaining （CR） and posterior cruciate substituting （PS） prosthesis in knee arthroplasty. Methods 64 patients with knee osteoarthritis were admitted to our department from June 2021 to June 2022 and whom met the selection criteria were randomly selected and divided into observation group and control group （n = 32）. CR prosthesis was used in the observation group， and PS prosthesis was used in the control group. Operation time， postoperative drainage volume， difference of hemoglobin （HGB） before and after operation， postoperative hospital stay， postoperative range of motion at 7 d， 14 d， 45 d， 3 months and 1 year were recorded. ROM， visual analog pain Scale （VAS）， Hospital for special surgery （HSS） score， and maximum forward and backward displacement of knee joint and the regular radiographs were also recorded， too. Results The two groups were similar in terms of operation time， postoperative hospital stay， postoperative VAS score and maximum anterior and posterior displacement of knee joint， with P values greater than 0.05， which had no statistical significance. The postoperative drainage volume in the observation group was significantly less than that in the control group， with statistical significance （P < 0.05）. The HGB difference of observation group was significantly lower than that of control group， with statistical significance （P < 0.05）. There was no statistically significant difference in ROM and HSS scores between the two groups before surgery； the ROM and HSS scores of the control group at 7， 14 and 45 days after surgery was better than that of the observation group， with statistical significance （P < 0.05）； the ROM and HSS scores of the two groups at 3 months after surgery was not statistically significant. The ROM and HSS scores in the observation group was better than that in the control group at 6 months and 1 year after operation， and the difference was statistically significant （P < 0.05）. Conclusions CR prosthesis is superior to PS prosthesis in terms of intraoperative blood loss and post?operative drainage volume， which can reduce surgical risk. Both kinds of prosthesis can achieve good knee stability after surgery， while PS prosthesis has better early clinical effect， while CR prosthesis has better long?term clinical effect.

Key words： knee joint; knee osteoarthritis; total knee arthroplasty; PS prosthesis; CR prosthesis

Cite this article

Shangzeng WANG , Bei ZHANG , Zhen WANG , Shang MA , Deyang RUANGZHANG , Zhiying YIN , Yunqi ZHU , Kunpeng HU , Shao CHENG . Comparison of the effects of CR and PS prostheses in the treatment of knee osteoarthritis[J]. The Journal of Practical Medicine, 2024 , 40(9) : 1251 -1256 . DOI: 10.3969/j.issn.1006-5725.2024.09.012

References

1 钱琨，于辰曦，李毅，等. 运动处方在膝骨性关节炎应用的进展［J］. 中国矫形外科杂志，2023，31（19）：1773-1777.
2 王文，王敏，孟庆奇，等. 单髁置换术与胫骨高位截骨术治疗膝关节内侧间室骨关节炎的疗效对比［J］. 实用医学杂志，2021，37（19）：2497-2500.
3 DOWSEY M M， GOULD D J， SPELMAN T， et al. A Randomized Controlled Trial Comparing a Medial Stabilized Total Knee Prosthesis to a Cruciate Retaining and Posterior Stabilized Design： A Report of the Clinical and Functional Outcomes Following Total Knee Replacement ［J］. J Arthroplasty， 2020，35（6）：1583-1590. doi:10.1016/j.arth.2020.01.085
4 HECKMANN N D， STECK T， SPORER S M， et al. Conforming Polyethylene Inserts in Total Knee Arthroplasty： Beyond the Posterior-Stabilized and Cruciate-Retaining Debate ［J］. J Am Acad Orthop Surg， 2021，29（22）：e1097-e1104. doi:10.5435/jaaos-d-20-01232
5 BROBERG J S， NDOJA S， MACDONALD S J， et al. Comparison of Contact Kinematics in Posterior-Stabilized and Cruciate-Retaining Total Knee Arthroplasty at Long-Term Follow-Up ［J］. J Arthroplasty， 2020，35（1）：272-277. doi:10.1016/j.arth.2019.07.046
6 MEI F， LI J， ZHANG L， et al. Posterior-Stabilized Versus Cruciate-Retaining Prostheses for Total Knee Arthroplasty： An Overview of Systematic Reviews and Risk of Bias Considerations ［J］. Indian J Orthop， 2022，56（11）：1858-1870. doi:10.1007/s43465-022-00693-6
7 LIU X， LIU Y， LI B， et al. Comparison of the clinical and patient-reported outcomes between medial stabilized and posterior stabilized total knee arthroplasty： A systematic review and meta-analysis ［J］. Knee， 2022，36：9-19. doi:10.1016/j.knee.2022.03.010
8 MOISAN P， BARIMANI B， KINDI M AL， et al. Semiconstrained posterior-stabilized total knee arthroplasty： indications， risks and benefits in primary and revision surgery ［J］. Can J Surg， 2023，66（2）：E103-E108. doi:10.1503/cjs.000622
9 张京新，梁伟，王永会，等. MB/CR假体与FB/PS假体全膝关节置换术早期疗效观察 ［J］.中国骨科临床与基础研究杂志，2015，7（4）：208-213. doi:10.3969/j.issn.1674-666X.2015.04.003
10 GRAY H A， GUAN S， YOUNG T J， et al. Comparison of posterior-stabilized， cruciate-retaining， and medial-stabilized knee implant motion during gait ［J］. J Orthop Res， 2020，38（8）：1753-1768. doi:10.1002/jor.24613
11 KANNA R， MURALI S M， RAMANATHAN A T， et al. Cruciate retaining total knee arthroplasty has a better 10 year survival than posterior stabilized total knee arthroplasty： a systematic review and meta-analysis ［J］. J Exp Orthop， 2023，10（1）：19. doi:10.1186/s40634-023-00583-2
12 KIM M S， KOH I J， KIM C K， et al. Comparison of Joint Perception Between Posterior-Stabilized and Ultracongruent Total Knee Arthroplasty in the Same Patient ［J］. J Bone Joint Surg Am， 2021，103（1）：44-52. doi:10.2106/jbjs.20.00279
13 JANG S W， KIM M S， KOH I J， et al. Comparison of Anterior-Stabilized and Posterior-Stabilized Total Knee Arthroplasty in the Same Patients： A Prospective Randomized Study ［J］. J Arthroplasty， 2019，34（8）：1682-1689. doi:10.1016/j.arth.2019.03.062
14 SONG S J， KIM K I， PARK C H. Comparison of risk for postoperative hyperextension between cruciate retaining and posterior stabilized total knee arthroplasties ［J］. Arch Orthop Trauma Surg， 2021，141（10）：1779-1788. doi:10.1007/s00402-021-03822-2
15 段于平，赵华磊，徐永升，等. 两种假体行全膝关节置换术治疗膝骨关节炎的疗效比较［J］. 临床骨科杂志， 2022，25（2）：202-206. doi:10.3969/j.issn.1008-0287.2022.02.016
16 徐一宏，年申生，韩学全，等. 全膝关节置换的后稳定型假体和保留后交叉韧带疗效比较［J］. 中华关节外科杂志（电子版），2020，14（6）：685-690.
17 高晨鑫，韩大鹏，丁浩源，等. 后交叉韧带保留型和后稳定型全膝关节假体治疗晚期膝骨关节炎早期关节遗忘度评价［J］.生物骨科材料与临床研究，2023，20（4）：46-50. doi:10.3969/j.issn.1672-5972.2023.04.010
18 廖新根，唐智明，吴梨华，等. 保留和不保留后交叉韧带的全膝关节置换治疗重度骨关节炎近期疗效前瞻对照研究［J］. 实用医学杂志， 2020，36（19）：2672-2677.
19 陈铭璁，陈扬，傅煊健. 后交叉韧带保留型假体与后稳定型假体全膝关节置换术后近期疗效比较［J］. 中国骨与关节损伤杂志， 2022，37（10）：1084-1087. doi:10.7531/j.issn.1672-9935.2022.10.022
20 万大地，段祥瑞，范鑫超，等. 后稳定型与后交叉韧带保留型膝关节假体在全膝关节置换中的疗效：系统综述和Meta分析［J］. 中国组织工程研究， 2021，25（36）：5897-5904.
21 李萍，柴恺. CR假体与PS假体对全膝关节置换术疗效的影响［J］. 河北医科大学学报，2021，42（1）：42-46+76. doi:10.3969/j.issn.1007-3205.2021.01.010
22 SONG S J， PARK C H， BAE D K. What to Know for Selecting Cruciate-Retaining or Posterior-Stabilized Total Knee Arthroplasty ［J］. Clin Orthop Surg， 2019，11（2）：142-150. doi:10.4055/cios.2019.11.2.142
23 廖新根，唐智明，吴梨华，等. 保留和不保留后交叉韧带的全膝关节置换治疗重度骨关节炎近期疗效前瞻对照研究［J］. 实用医学杂志， 2020，36（19）：2672-2677.
24 PERKINS M R， ARNHOLT C M， MACDONALD D W， et al. Retrieval Analysis of Cruciate-Retaining and Posterior-Stabilized Total Knee Arthroplasty and Correlations to Laxity and Wear ［J］. J Arthroplasty， 2020，35（8）：2249-2253. doi:10.1016/j.arth.2020.03.027
25 SINGLETON N， NICHOLAS B， GORMACK N， et al. Differences in outcome after cruciate retaining and posterior stabilized total knee arthroplasty ［J］. J Orthop Surg （Hong Kong）， 2019，27（2）：2309499019848154. doi:10.1177/2309499019848154
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