title: Cruciate retaining and cruciate substituting ultra-congruent insert.
abstract: The posterior cruciate ligament (PCL) conservation and the polyethylene insert constraint in total knee arthroplasty (TKA) are still debated. The PCL is one of the primary stabilizers of the joint, but cruciate retaining (CR) implants have the disadvantage of a difficult balancing of the PCL. Postero-stabilized (PS) implants were introduced to reduce this problem. However, also the PS implants have some disadvantages, due to the cam-mechanism, such as high risk of cam-mechanism polyethylene wear. To minimize the polyethylene wear of the cam-mechanism and the bone sacrifice due to the intercondylar box, different types of inserts were developed, trying to increase the implant conformity and to reduce stresses on the bone-implant interface. In this scenario ultra-congruent (UC) inserts were developed. Those inserts are characterized by a high anterior wall and a deep-dished plate. This conformation should guarantee a good stability without the posterior cam. Few studies on both kinematic and clinical outcomes of UC inserts are available. Clinical and radiological outcomes, as well as kinematic data are similar between UC mobile bearing (MB) and standard PS MB inserts at short to mid-term follow-up. In this manuscript biomechanics and clinical outcomes of UC inserts will be described, and they will be compared to standard PS or CR inserts.
authors: 1 University of Study of Torino, Via Po 8, 10123 Torino, Italy ; 2 AO Ordine Mauriziano, Largo Filippo Turati 62, 10128 Torino, Italy.
authors: Luca
authors: L
authors: Mazzucchelli
authors: 1 University of Study of Torino, Via Po 8, 10123 Torino, Italy ; 2 AO Ordine Mauriziano, Largo Filippo Turati 62, 10128 Torino, Italy.
authors: Davide
authors: D
authors: Deledda
authors: 1 University of Study of Torino, Via Po 8, 10123 Torino, Italy ; 2 AO Ordine Mauriziano, Largo Filippo Turati 62, 10128 Torino, Italy.
authors: Federica
authors: F
authors: Rosso
authors: 1 University of Study of Torino, Via Po 8, 10123 Torino, Italy ; 2 AO Ordine Mauriziano, Largo Filippo Turati 62, 10128 Torino, Italy.
authors: Nicola
authors: N
authors: Ratto
authors: 1 University of Study of Torino, Via Po 8, 10123 Torino, Italy ; 2 AO Ordine Mauriziano, Largo Filippo Turati 62, 10128 Torino, Italy.
authors: Matteo
authors: M
authors: Bruzzone
authors: 1 University of Study of Torino, Via Po 8, 10123 Torino, Italy ; 2 AO Ordine Mauriziano, Largo Filippo Turati 62, 10128 Torino, Italy.
authors: Davide Edoardo
authors: DE
authors: Bonasia
authors: 1 University of Study of Torino, Via Po 8, 10123 Torino, Italy ; 2 AO Ordine Mauriziano, Largo Filippo Turati 62, 10128 Torino, Italy.
authors: Roberto
authors: R
authors: Rossi
keywords: Total knee arthroplasty (TKA); polyethylene insert; posterior cruciate ligament (PCL); total knee arthroplasty kinematics; ultra-congruent (UC) insert