title: Similar stability and range of motion between cruciate-retaining and cruciate-substituting ultracongruent insert total knee arthroplasty.
abstract: OBJECTIVE
  The use of an ultracongruent (UC) insert with a standard femoral component for substitution of the posterior cruciate ligament (PCL) is a bone-preserving and therefore interesting alternative to the established box and cam mechanism of posterior-stabilized total knee arthroplasty (TKA). Despite the regular use of these UC inserts, there is little evidence about stability and range of motion (ROM).
  
  
  METHODS
  The aim of this study was to evaluate the stability and ROM in standard cruciate-retaining (CR) and cruciate-substituting UC inserts of the same TKA. In 39 patients, intraoperative measurements of stability and ROM were taken (1) before soft tissue release and bone cuts, (2) after implantation of a CR TKA and (3) after resection of the PCL and substitution with an UC insert. All measurements were taken using a navigation system.
  
  
  RESULTS
  Stability measurements demonstrated no differences between CR (PCL intact) and UC TKA (PCL resected), but significantly increased anteroposterior translation at 60° and 90° of knee flexion compared with the preoperative condition. ROM measurements demonstrated improvement of knee flexion from preoperatively mean 105° (SD 14.1°) to intraoperative 120.2° (SD 6.7°) with the CR and 121.0° (SD 7.5°) with the UC insert and 113.5° (SD 14.0°) at the 1-year follow-up.
  
  
  CONCLUSIONS
  This study demonstrates similar stability of an UC insert compared with a standard CR insert. UC inserts are therefore a bone-preserving solution if the PCL needs to be substituted. ROM was not improved after resection of the PCL and substitution with the UC insert.
  
  
  METHODS
  II.
authors: Department of Orthopaedic Surgery, Medical Faculty, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany, Joerg.Luetzner@uniklinikum-dresden.de.
authors: Jörg
authors: J
authors: Lützner
authors: F-P
authors: FP
authors: Firmbach
authors: C
authors: C
authors: Lützner
authors: J
authors: J
authors: Dexel
authors: S
authors: S
authors: Kirschner
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods*; D001696:Biomechanical Phenomena / Q000502:physiology; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology* / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D011474:Prosthesis Design; D016059:Range of Motion, Articular / Q000502:physiology*; D012399:Rotation; D025321:Surgery, Computer-Assisted