Outcomes of Posterior Cruciate Ligament Retaining versus Posterior Cruciate Ligament Sacrificing in Total Knee Replacement in Young Population -Meta-Analysis of 10 Years of Studies
Meta Analysis
DOI:
https://doi.org/10.31282/joti.v4n2.75Keywords:
total knee arthroplasty, posterior cruciate ligament, PCL-retaining, PCL-sacrificingAbstract
Introduction: Total knee arthroplasty (TKA) is a common procedure performed especially in end-stage knee osteoarthritis (OA). Since the posterior cruciate ligament (PCL) may affect knee stability, it has been debated whether the PCL needs to be preserved or sacrificed. This study aims to systematically analyze the clinical and functional outcomes following TKA with PCL retaining (PCLR) and sacrificing (PCLS).
Methods: A systematic search was performed through online databases (PubMed, Google Scholar and Cochrane Library) based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline within the searching period from 2011 to 2021. Studies involving patients undergoing total knee replacement with PCL retaining or sacrificing method for knee OA with minimum follow-up of 12 months were included. Non-comparative studies, animal studies and non-English studies were excluded. Review Manager (RevMan) Version 5.3 was used to analyze mean difference (MD) and odds ratio (OR) with a 95% confidence interval (CI).
Results: There were 194 studies on the initial search, 72 duplicates were removed and the final remaining 7 studies were used for inclusion. Seven studies with a total of 3346 patients were included. There were 2220 patients (66.35%) underwent TKA with PCL retaining method. Analyses revealed no significant difference in range of motion (ROM), knee score, maximum flexion, the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and pain score between PCLR and PCLS with p-values of 0.10, 0.56, 0.42, 0.33 and 0.67, respectively. Only function score, hospital for special surgery (HSS) score and flexion contracture showed significant differences with p-values of 0.0002, 0.002 and 0.004, respectively. Further studies are needed.
Conclusion: Analysis between PCLR and PCLS showed no significant difference on the clinical or functional outcomes except in postoperative function score, flexion contracture and HSS score. PCLR had significantly higher function and HSS score with lower flexion contracture compared to PCLS.
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