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Posterior condylar offset changes and its effect on clinical outcomes after posterior-substituting, fixed-bearing total knee arthroplasty: anterior versus posterior referencing

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Authors

Chang, Moon Jong; Kang, Seung-Baik; Chang, Chong Bum; Han, Do Hwan; Park, Hyung Jun; Hwang, Keummin; Park, Jisu; Hwang, Il-Ung; Lee, Seung A; Oh, Sohee

Issue Date
2019-12-31
Publisher
BMC
Citation
Knee Surgery & Related Research, 32(1):10
Keywords
Anterior referencing systemPosterior referencing systemPosterior condylar offsetPosterior condylar offset ratio
Abstract
Background
We sought to determine whether there was a difference in the posterior condylar offset (PCO), posterior condylar offset ratio (PCOR) and clinical outcomes following total knee arthroplasty (TKA) with anterior referencing (AR) or posterior referencing (PR) systems. We also assessed whether the PCO and PCOR changes, as well as patient factors were related to range of motion (ROM) in each referencing system.

Methods
This retrospective study included 130 consecutive patients (184 knees) with osteoarthritis who underwent primary posterior cruciate ligament (PCL)-substituting fixed-bearing TKA. The difference between preoperative and postoperative PCO and PCOR values were calculated. Clinical outcomes including ROM and Western Ontario and McMaster University (WOMAC) scores were evaluated. Furthermore, multiple linear regression analysis was performed to determine the factors related to postoperative ROM in each referencing system.

Results
The postoperative PCO was greater in the AR group (28.4 mm) than in the PR group (27.4 mm), whereas the PCO was more consistently preserved in the PR group. The mean postoperative ROM after TKA was greater in the AR group (129°) than in the PR group (122°), whereas improvement in WOMAC score did not differ between the two groups. Preoperative ROM was the only factor related to postoperative ROM in both groups.

Conclusions
There was no difference in postoperative PCO in AR and PR group and the PCO was not associated with postoperative ROM. PCO was more consistently preserved after surgery in the PR group. The postoperative PCO and PCOR changes did not affect the postoperative ROM. Furthermore, similar clinical outcomes were achieved in the AR and PR groups.

Trial registration
Retrospectively registered (Trial registration number: 06-2010-110).
ISSN
1225- 1623
Language
English
URI
https://doi.org/10.1186/s43019-019-0022-2

https://hdl.handle.net/10371/164908
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