Retention Versus Sacrifice of Posterior Cruciate Ligament During Mobile-Bearing Total Knee Arthroplasty: A Meta-Analysis
Yuan-Shi Zhang1, Gui-Zhou Zheng1, Shi-Xin Du1 and Xue-Dong Li1*
1Department of Orthopedics, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen, Guangdong 518000, P.R. China.
*Corresponding Author: Dr. Xue-Dong Li, Department of Orthopedics, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen, Guangdong 518000, P.R. China.
Received: March 30, 2022 Published: April 30, 2022
Abstract
Background: Although the superiority of posterior cruciate ligament (PCL) for mobile-bearing (MB) TKA remains debated, there remains a lack of high-quality evidence based studies such as meta-analyses of comparative studies, so we performed a meta-analysis of comparative studies to determine whether there is a significant difference between PCL retention (CR) and PCL sacrifice (PS) mobile-bearing (MB) in terms of clinical and functional knee scores, kinematic function, rate of complications and revision.
Methods: We searched literatures comprehensively published by May 2020 in databases including MEDLINE, Cochrane databases and Embase, and the RevMan 5.3 was used to perform this meta-analysis.
Results: 6 RCTs and 6 comparative observational studies (Obs) on this topic were integrated. There were no significant differences between the two procedures in the Hospital for Special Surgery score (HSS), Knee Society Knee Score (KSS), Knee Society Functional score (KSFS), Western Ontario McMasters University index (WOMAC), knee range of motion (ROM)， and varus–valgus laxity. Even CR MB was slightly superior to PS MB regarding New Jersey Knee score (NJKS), PS MB was superior to CR MB with respect to complications rate and revision rate.
Conclusions: The meta-analysis revealed that CR MB and PS MB could achieve similar clinical outcomes, whereas the rate of complications and revision was significantly increased in CR MB. Based on the outcomes of this meta-analysis, the choice of the CR MB does not appear to be justified, and further studies of high methodological quality with long-term follow-up are required to confirm our conclusion.
Keywords: Posterior cruciate ligament (PCL), Fixed-bearing (FB), Meta-analysis, Knee score system
Citation: Shi Zhang Y, Zhou Zheng G, Xin Du S, Dong Li X. “Retention Versus Sacrifice of Posterior Cruciate Ligament During Mobile-Bearing Total Knee Arthroplasty: A Meta-Analysis”. SVOA Orthopaedics 2022 (2:2) 50-60.