A Cam-Post Mechanism Is No Longer Necessary in Modern Primary Total Knee Arthroplasty

R. Meneghini, Michael D. Stefl, W. Andrew Hodge, Scott A. Banks

Research output: Contribution to journalArticle

Abstract

Conclusive evidence supporting a clinical difference between posterior-stabilized (PS) and cruciate-retaining (CR) designs in total knee arthroplasty (TKA) does not currently exist, despite both designs being used for decades. Proponents of PS designs that employ a cam-and-post mechanism cite in vivo fluoroscopic data that demonstrate improved posterior rollback; however, optimal rollback has never been correlated to superior clinical outcomes. Recently, anterior-lipped and more conforming CR bearings, such as ultracongruent, medial pivot, and dual-pivot designs, have been used to substitute for the posterior cruciate ligament and obviate the need for the cam-post mechanism of a traditional PS design. Advantages of avoiding a PS TKA include eliminating the risk of box cut induced femoral condylar fracture, improving operative efficiency by removing procedural steps, removing the articulation that is a source of wear, postdeformation, breakage, or dislocation, and eliminating patellar clunk. Health care reform efforts mandate cost reduction, and procedural efficiencies and minimizing inventory through the removal of unnecessary bearing options foster that initiative.

Original languageEnglish (US)
Pages (from-to)710-713
Number of pages4
JournalJournal of Knee Surgery
Volume32
Issue number8
DOIs
StatePublished - Jan 1 2019

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Knee Replacement Arthroplasties
Patellar Dislocation
Posterior Cruciate Ligament
Femoral Fractures
Health Care Reform
Costs and Cost Analysis
Equipment and Supplies

Keywords

  • cam-post
  • knee kinematics
  • posterior-stabilized articulations
  • total knee arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

A Cam-Post Mechanism Is No Longer Necessary in Modern Primary Total Knee Arthroplasty. / Meneghini, R.; Stefl, Michael D.; Hodge, W. Andrew; Banks, Scott A.

In: Journal of Knee Surgery, Vol. 32, No. 8, 01.01.2019, p. 710-713.

Research output: Contribution to journalArticle

Meneghini, R. ; Stefl, Michael D. ; Hodge, W. Andrew ; Banks, Scott A. / A Cam-Post Mechanism Is No Longer Necessary in Modern Primary Total Knee Arthroplasty. In: Journal of Knee Surgery. 2019 ; Vol. 32, No. 8. pp. 710-713.
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