Summary
BCS-TKA resulted in significantly better stair climbing ability when compared with CR or PS TKA.
Abstract
Purpose
The purpose of this study was to compare stair climbing and descent ability following bi-cruciate substituting (BCS), cruciate retaining (CR), and posterior stabilizing (PS) total knee arthroplasties (TKA).
Methods
63 subjects undergoing BCS-TKA (Journey II: Smith and Nephew), 47 subjects undergoing CR-TKA (FINE: Teijin Nakashima Medical), and 38 subjects undergoing PS-TKA (FNK: Teijin Nakashima Medical) were included in this study. Before and 12 months after surgery, a questionnaire was administered to assess daily stair climbing and descent ability. In the questionnaire, stair climbing and descent ability was classified as 1) stair climbing and descent one step at a time, 2) stair climbing and descent two steps at a time, and 3) unable to climb or descend stairs. The necessity of a handrail was also evaluated and classified as 1) necessary, 2) unnecessary, and 3) unable to climb or descend stairs with handrail. Statistical analysis (?2 test) was performed to compare these data between the types of TKA.
Results
Pre-operatively, no significant differences in stair climbing and descent ability or between handrail classifications were observed between the types of TKA. Post-operatively, the percentage of patients able to climb stairs one step at a time was significantly higher in BCS-TKA (89%), when compared with CR (72%) or PS (58%) TKAs. No significant differences in stair descent ability or among the handrail necessity classifications were observed between the types of TKA.
Conclusion
BCS-TKA resulted in significantly better stair climbing ability when compared with CR or PS TKA. This may indicate that the design of BCS-TKA better reproduces native ACL and PCL function and improves knee stability during stair climbing activity.