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J Arthroplasty. 2013 Feb;28(2):234-242.e1. doi: 10.1016/j.arth.2012.05.010. Epub 2012 Jul 17.

Cruciate-retaining vs posterior-substituting inserts in total knee arthroplasty: functional outcome comparison.

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Orthopaedic Surgery Department, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.


Despite clinical success, it is unclear which one, posterior-substituting (PS) or cruciate-retaining (CR) insert, has superior functional outcomes or longevity. We compared the collected results from 2 institutional review board-approved, multicenter, prospective observational studies following CR (412) and PS inserts (328). Participants were evaluated preoperatively, at 6 weeks, at 3 months, and at 1 and 2 years regarding pain, motion, function (Knee Society Score, Krackow Activity Score, Short Form-36), and procedure variables such as anesthesia and preoperative/perioperative/postoperative complications. Implant longevity was recorded at the 2-year follow-up. Improvement was observed within each group; however, there was no difference between groups in terms of pain, motion, or function at any end point. Two-year survival rate was higher than 95%. A higher incidence of wound hematoma was observed in the PS group. Both inserts can be used expecting satisfactory outcomes and high survival rates at 2 years.

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