Balancing Precision and Constraint: A Comparative Study of Cruciate-Retaining and Posterior-Stabilized Total Knee Arthroplasty

Total Knee Arthroplasty (TKA) is an established procedure for end-stage knee arthritis, but whether to preserve or sacrifice the posterior cruciate ligament (PCL) remains contentious. Cruciate-Retaining (CR) and Posterior-Stabilized (PS) implants provide different biomechanical benefits, but the relative impact on functional outcomes in everyday living is unknown. The objective of this study was to examine: "Does maintaining the native PCL offer meaningful clinical benefits compared to sacrificing it in primary TKA?" The study aimed to determine whether CR or PS implant designs result in superior functional recovery lower complication rates, or improved subjective outcomes, or whether both perform equivalently in primary TKA. Retrospective study was done in 69 patients (90 knees) who had primary TKA with CR or PS designs at Karuna Medical College and Hospital. Functional outcomes were measured in terms of Knee Society Scores (KSKS, KSFS), Range of Motion (ROM), and WOMAC improvement. Complication rates and deformity patterns were also noted. Independent samples t-tests and Fisher's Exact Test were applied to compare the groups' outcomes. Both implant designs showed great postoperative outcomes. No statistically significant differences were present for ROM, KSKS, KSFS, or complications. The significant difference was increased WOMAC improvement in the PS group (p = 0.007). Aside from subjective WOMAC improvement in PS recipients, CR and PS implants are clinically equivalent. Implant selection should be individualized, based on ligament status and surgical condition, and not preference in general.