title: Posterior Cruciate Ligament Retention versus Posterior Stabilization for Total Knee Arthroplasty: A Meta-Analysis.
abstract: BACKGROUND
  Although being debated for many years, the superiority of posterior cruciate-retaining (CR) total knee arthroplasty (TKA) and posterior-stabilized (PS) TKA remains controversial. We compare the knee scores, post-operative knee range of motion (ROM), radiological outcomes about knee kinematic and complications between CR TKA and PS TKA.
  
  
  METHODS
  Literature published up to August 2015 was searched in PubMed, Embase and Cochrane databases, and meta-analysis was performed using the software, Review Manager version 5.3.
  
  
  RESULTS
  Totally 14 random control trials (RCTs) on this topic were included for the analysis, which showed that PS and CR TKA had no significant difference in Knee Society knee Score (KSS), pain score (KSPS), Hospital for Special Surgery score (HSS), kinematic characteristics including postoperative component alignment, tibial posterior slope and joint line, and complication rate. However, PS TKA is superior to CR TKA regarding post-operative knee range of motion (ROM) [Random Effect model (RE), Mean Difference (MD) = -7.07, 95% Confidential Interval (CI) -10.50 to -3.65, p<0.0001], improvement of ROM (Fixed Effect model (FE), MD = -5.66, 95% CI -10.79 to -0.53, p = 0.03) and femoral-tibial angle [FE, MD = 0.85, 95% CI 0.46 to 1.25, p<0.0001].
  
  
  CONCLUSIONS
  There are no clinically relevant differences between CR and PS TKA in terms of clinical, functional, radiological outcome, and complications, while PS TKA is superior to CR TKA in respects of ROM, while whether this superiority matters or not in clinical practice still needs further investigation and longer follow-up.
authors.affiliation: Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
authors.forename: Zhenlei
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Bian
authors.affiliation: Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Feng
authors.affiliation: Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
authors.forename: Xisheng
authors.initials: X
authors.lastname: Weng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D020370:Osteoarthritis, Knee / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*; D016119:Posterior Cruciate Ligament / Q000473:pathology / Q000601:surgery*; D011184:Postoperative Period; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology
references.citation: J Arthroplasty. 2002 Oct;17(7):813-9
references.pmid: 12375237
references.citation: J Arthroplasty. 2012 Mar;27(3):368-74
references.pmid: 21680139
references.citation: Clin Orthop Relat Res. 2001 Nov;(392):208-12
references.pmid: 11716384
references.citation: J Arthroplasty. 2012 Oct;27(9):1723-30
references.pmid: 22554731
references.citation: Knee Surg Sports Traumatol Arthrosc. 2014 Dec;22(12):3135-41
references.pmid: 25100487
references.citation: J Bone Joint Surg Br. 2003 Apr;85(3):389-92
references.pmid: 12729115
references.citation: Clin Orthop Relat Res. 1994 Aug;(305):218-22
references.pmid: 8050232
references.citation: Chang Gung Med J. 2004 Aug;27(8):578-85
references.pmid: 15553604
references.citation: J Bone Joint Surg Am. 2008 Dec;90(12):2579-86
references.pmid: 19047702
references.citation: J Arthroplasty. 2004 Oct;19(7 Suppl 2):107-12
references.pmid: 15457428
references.citation: BMC Musculoskelet Disord. 2013;14:127
references.pmid: 23565578
references.citation: J Arthroplasty. 2004 Apr;19(3):349-53
references.pmid: 15067650
references.citation: Knee. 2012 Aug;19(4):246-52
references.pmid: 22300844
references.citation: Acta Orthop. 2015 Apr;86(2):195-201
references.pmid: 25323799
references.citation: J Clin Pathol. 2001 May;54(5):381-4
references.pmid: 11328838
references.citation: Knee. 2008 Jun;15(3):217-21
references.pmid: 18325770
references.citation: J Bone Joint Surg Am. 2004 Feb;86-A(2):328-34
references.pmid: 14960678
references.citation: J Clin Med Res. 2015 Mar;7(3):171-5
references.pmid: 25584102
references.citation: Knee Surg Sports Traumatol Arthrosc. 2014 Mar;22(3):556-64
references.pmid: 23117166
references.citation: J Bone Joint Surg Am. 2009 Apr;91(4):753-60
references.pmid: 19339558
references.citation: Knee Surg Sports Traumatol Arthrosc. 2011 Dec;19(12):2016-22
references.pmid: 21331651
references.citation: J Bone Joint Surg Br. 2003 Jul;85(5):671-4
references.pmid: 12892188
references.citation: J Arthroplasty. 2004 Sep;19(6):775-82
references.pmid: 15343540
references.citation: J Bone Joint Surg Br. 2005 May;87(5):646-55
references.pmid: 15855366
references.citation: J Arthroplasty. 2013 Mar;28(3):439-44
references.pmid: 23433255