RCT of Anterior-stabilized TKA Versus PS or CR — Giving the Findings Some Key Context

What would make you try something new?

What’s the Claim?

A well-designed randomized clinical trial found no differences at two years among posterior stabilized (cruciate-substituting), cruciate-retaining, and the new kid on the block, “anterior-stabilized” TKA, in terms of knee scores for pain and function, satisfaction, and general health patient-reported outcomes. Range of motion favored the PS TKAs by a few degrees.

I loved the trial but had a beef with the take-home message, which was: “All three designs are viable options for primary TKA in uncomplicated OA knees.” I believe that in the absence of compelling advantages to a new design philosophy, if the available options have been shown reliable over the long term — as is the case with CR and PS — then one should shun the new approach until or unless it is proven superior in some meaningful way. More on that in a moment.

How’s It Stack Up?