open access

Vol 76, No 1 (2017)
ORIGINAL ARTICLES
Published online: 2016-08-24
Submitted: 2016-05-31
Accepted: 2016-08-01
Get Citation

An evaluation of the posterior cruciate ligament function in total knee arthroplasty with regard to its morphology and clinical properties

D. Marczak, J. Kowalczewski, T. Okoń, M. Synder, M. Sibiński
DOI: 10.5603/FM.a2016.0047
·
Pubmed: 27665954
·
Folia Morphol 2017;76(1):94-99.

open access

Vol 76, No 1 (2017)
ORIGINAL ARTICLES
Published online: 2016-08-24
Submitted: 2016-05-31
Accepted: 2016-08-01

Abstract

The aim of the study was to determine the degree of posterior cruciate ligament (PCL) degeneration and the reduction in the number of its mechanoreceptors, in patients with advanced degenerative joint disease. PCLs taken from study group of 50 patients in the mean age of 70.7 (53–84) years with a diagnosis of advanced idiopathic osteoarthritis undergoing condylar total knee arthroplasty were compared to those taken form the control group of 10 knee joints of cadavers. Groups were matched with regard to sex and age. Histological examination of PCLs of the study group showed changes of an inflammatory process and no significant signs of osteoarthritis in the control group. A close correlation was found between the severity of degenerative changes on the X-ray images according to the Ahlbäck scale, and the increased mucoid degeneration (p < 0.0001), the severity of the degeneration of the collagen structure (p < 0.0001) and the presence of proprioceptors of PCLs (p < 0.0001). Conserving the PCL by the use of type cruciate retaining knee arthroplasty does not guarantee the preservation of correct proprioceptive sensation.

Abstract

The aim of the study was to determine the degree of posterior cruciate ligament (PCL) degeneration and the reduction in the number of its mechanoreceptors, in patients with advanced degenerative joint disease. PCLs taken from study group of 50 patients in the mean age of 70.7 (53–84) years with a diagnosis of advanced idiopathic osteoarthritis undergoing condylar total knee arthroplasty were compared to those taken form the control group of 10 knee joints of cadavers. Groups were matched with regard to sex and age. Histological examination of PCLs of the study group showed changes of an inflammatory process and no significant signs of osteoarthritis in the control group. A close correlation was found between the severity of degenerative changes on the X-ray images according to the Ahlbäck scale, and the increased mucoid degeneration (p < 0.0001), the severity of the degeneration of the collagen structure (p < 0.0001) and the presence of proprioceptors of PCLs (p < 0.0001). Conserving the PCL by the use of type cruciate retaining knee arthroplasty does not guarantee the preservation of correct proprioceptive sensation.

Get Citation

Keywords

posterior cruciate ligament, osteoarthritis, knee replacement, proprioception, function

About this article
Title

An evaluation of the posterior cruciate ligament function in total knee arthroplasty with regard to its morphology and clinical properties

Journal

Folia Morphologica

Issue

Vol 76, No 1 (2017)

Pages

94-99

Published online

2016-08-24

DOI

10.5603/FM.a2016.0047

Pubmed

27665954

Bibliographic record

Folia Morphol 2017;76(1):94-99.

Keywords

posterior cruciate ligament
osteoarthritis
knee replacement
proprioception
function

Authors

D. Marczak
J. Kowalczewski
T. Okoń
M. Synder
M. Sibiński

References (24)
  1. Ahlbäck S. Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh), 1968; Suppl 277: 7–72.
  2. Akisue T, Stulberg BN, Bauer TW, et al. Histologic evaluation of posterior cruciate ligaments from osteoarthritic knees. Clin Orthop Relat Res. 2002(400): 165–173.
  3. Allain J, Goutallier D, Voisin MC. Macroscopic and histological assessments of the cruciate ligaments in arthrosis of the knee. Acta Orthop Scand. 2001; 72(3): 266–269.
  4. Barrett DS, Cobb AG, Bentley G. Joint proprioception in normal, osteoarthritic and replaced knees. J Bone Joint Surg Br. 1991; 73(1): 53–56.
  5. Bolanos AA, Colizza WA, McCann PD, et al. A comparison of isokinetic strength testing and gait analysis in patients with posterior cruciate-retaining and substituting knee arthroplasties. J Arthroplasty. 1998; 13(8): 906–915.
  6. Cash RM, Gonzalez MH, Garst J, et al. Proprioception after arthroplasty: role of the posterior cruciate ligament. Clin Orthop Relat Res. 1996(331): 172–178.
  7. Chaudhary R, Beaupré LA, Johnston DWC. Knee range of motion during the first two years after use of posterior cruciate-stabilizing or posterior cruciate-retaining total knee prostheses. A randomized clinical trial. J Bone Joint Surg Am. 2008; 90(12): 2579–2586.
  8. Gigante A, Specchia N, Greco F. Age-related distribution of elastic fibers in the rabbit knee. Clin Orthop Relat Res. 1994(308): 33–42.
  9. Katonis PG, Assimakopoulos AP, Agapitos MV, et al. Mechanoreceptors in the posterior cruciate ligament. Histologic study on cadaver knees. Acta Orthop Scand. 1991; 62(3): 276–278.
  10. Kim YH, Choi Y, Kwon OR, et al. Functional outcome and range of motion of high-flexion posterior cruciate-retaining and high-flexion posterior cruciate-substituting total knee prostheses. A prospective, randomized study. J Bone Joint Surg Am. 2009; 91(4): 753–760.
  11. Kleinbart FA, Bryk E, Evangelista J, et al. Histologic comparison of posterior cruciate ligaments from arthritic and age-matched knee specimens. J Arthroplasty. 1996; 11(6): 726–731.
  12. Lattanzio PJ, Chess DG, MacDermid JC. Effect of the posterior cruciate ligament in knee-joint proprioception in total knee arthroplasty. J Arthroplasty. 1998; 13(5): 580–585.
  13. Nelissen RG, Hogendoorn PC. Retain or sacrifice the posterior cruciate ligament in total knee arthroplasty? A histopathological study of the cruciate ligament in osteoarthritic and rheumatoid disease. J Clin Pathol. 2001; 54(5): 381–384.
  14. Pagnano MW, Cushner FD, Scott WN. Role of the posterior cruciate ligament in total knee arthroplasty. J Am Acad Orthop Surg. 1998; 6(3): 176–187.
  15. Schultz RA, Miller DC, Kerr CS, et al. Mechanoreceptors in human cruciate ligaments. A histological study. J Bone Joint Surg Am. 1984; 66(7): 1072–1076.
  16. Schwab JH, Haidukewych GJ, Hanssen AD, et al. Flexion instability without dislocation after posterior stabilized total knees. Clin Orthop Relat Res. 2005; 440: 96–100.
  17. Shannon FJ, Cronin JJ, Cleary MS, et al. The posterior cruciate ligament-preserving total knee replacement: do we 'preserve' it? A radiological study. J Bone Joint Surg Br. 2007; 89(6): 766–771.
  18. Simmons S, Lephart S, Rubash H, et al. Proprioception following total knee arthroplasty with and without the posterior cruciate ligament. J Arthroplasty. 1996; 11(7): 763–768.
  19. Skinner HB, Barrack RL. Joint position sense in the normal and pathologic knee joint. J Electromyogr Kinesiol. 1991; 1(3): 180–190.
  20. Straw R, Kulkarni S, Attfield S, et al. Posterior cruciate ligament at total knee replacement. Essential, beneficial or a hindrance? J Bone Joint Surg Br. 2003; 85(5): 671–674.
  21. Stubbs G, Dahlstrom J, Papantoniou P, et al. Correlation between macroscopic changes of arthrosis and the posterior cruciate ligament histology in the osteoarthritic knee. ANZ J Surg. 2005; 75(12): 1036–1040.
  22. Swanik CB, Lephart SM, Rubash HE. Proprioception, kinesthesia, and balance after total knee arthroplasty with cruciate-retaining and posterior stabilized prostheses. J Bone Joint Surg Am. 2004; 86-A(2): 328–334.
  23. Udomkiat P, Meng BJ, Dorr LD, et al. Functional comparison of posterior cruciate retention and substitution knee replacement. Clin Orthop Relat Res. 2000(378): 192–201.
  24. Wang CJ, Wang JW, Chen HS. Comparing cruciate-retaining total knee arthroplasty and cruciate-substituting total knee arthroplasty: a prospective clinical study. Chang Gung Med J. 2004; 27(8): 578–585.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By  "Via Medica sp. z o.o." sp.k., Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl