Mehmet Fatih Guven1, Bedri Karaismailoglu1, Eyyup Kara2, Serpil Hulya Ahmet3, Cevaydin Guler4, Okan Tok5, Mahmut Kursat Ozsahin1, Önder Aydıngöz1. 1. Department of Orthopaedics and Traumatology, Cerrahpasa Medical Faculty, 532719Istanbul University-Cerrahpasa, Istanbul, Turkey. 2. Department of Audiology, 532719Istanbul University-Cerrahpasa, Istanbul, Turkey. 3. Department of Audiology, 52946Bahcesehir University, Istanbul, Turkey. 4. Department of Orthopaedics and Traumatology, 567570Sancaktepe Training and Research Hospital, Istanbul, Turkey. 5. 64296Acıbadem Altunizade Hospital, Istanbul, Turkey.
Abstract
PURPOSE: This study aimed to evaluate whether the posterior cruciate ligament sacrifice during total knee arthroplasty (TKA) has any effect on postoperative standing balance or not. METHODS: The patients who underwent bilateral TKA with either CR or PS design were analyzed. 30 patients (10 PS, 20 CR) were included for the final analysis. TKA designs were compared in terms of Lysholm score, range of motion, and balance characteristics including somatosensorial, vestibular, and visual balance scales, adaptation, limits of stability, and weight-bearing/squat tests by computerized dynamic posturography. RESULTS: The mean follow-up time was 59 months for CR, 49 months for PS group. The average Lysholm score values were 94 for CR and 95 for PS group, indicating functionally similar patient groups. The average knee flexion was found significantly higher in PS group (114°) compared to CR group (102°) (p = 0.009). In the CR group, motor adaptation tests (toes up/toes down) were found to be better (p = 0.034). In the on-axis velocity parameter (linear goal orientation) of limits of stability test, PS group patients were found to be more successful (p = 0.035). CONCLUSIONS: The use of CR implants can be recommended in patients with a high risk of falling since they provide better motor adaptation providing rapid reactions to rapid surface changes. Better linear goal orientation in PS group, providing a faster movement in an intended direction, should be considered when planning the ideal implant for the patients with relevant activities.
PURPOSE: This study aimed to evaluate whether the posterior cruciate ligament sacrifice during total knee arthroplasty (TKA) has any effect on postoperative standing balance or not. METHODS: The patients who underwent bilateral TKA with either CR or PS design were analyzed. 30 patients (10 PS, 20 CR) were included for the final analysis. TKA designs were compared in terms of Lysholm score, range of motion, and balance characteristics including somatosensorial, vestibular, and visual balance scales, adaptation, limits of stability, and weight-bearing/squat tests by computerized dynamic posturography. RESULTS: The mean follow-up time was 59 months for CR, 49 months for PS group. The average Lysholm score values were 94 for CR and 95 for PS group, indicating functionally similar patient groups. The average knee flexion was found significantly higher in PS group (114°) compared to CR group (102°) (p = 0.009). In the CR group, motor adaptation tests (toes up/toes down) were found to be better (p = 0.034). In the on-axis velocity parameter (linear goal orientation) of limits of stability test, PS group patients were found to be more successful (p = 0.035). CONCLUSIONS: The use of CR implants can be recommended in patients with a high risk of falling since they provide better motor adaptation providing rapid reactions to rapid surface changes. Better linear goal orientation in PS group, providing a faster movement in an intended direction, should be considered when planning the ideal implant for the patients with relevant activities.
Entities:
Keywords:
balance; comparative study; cruciate-retaining; cruciate-substituting; dynamic; level of evidence: level III; posturography; total knee arthroplasty