Dr. Merrill Ritter, an outstanding expert on total knee replacement (TKR), has written an interesting paper evaluating results with posterior cruciate retaining (PCR) and posterior-substituting total knee replacement (PS). His center is a high-volume center for total knee replacement, and the study encompasses results in 8,607 total knee replacements. His findings demonstrate an expected slight increase in flexion for the PS TKR in comparison to the PCR TKR (about 3°) with slightly better function in the PCR TKR. However, the results varied from surgeon to surgeon in the group using these different implants, and this was a major variable in the results. Surgeon results varied and were not consistently better with one implant or another. Some surgeons had excellent results with the PCR knee and others less good results with the PCR knee. The same was true for the PS TKR. This led to the conclusion that surgeon preference and experience with a particular implant was the important variable in patient outcome.
Commentary on article by Merrill A. Ritter, MD et al.: The surgeonís role in relative success of PCL retaining and PCL-substituting total knee arthroplasty
HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.