Total knee replacement: PFC replacement (De Puy-Synthes)
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There are two principle designs of the PFC, a posterior cruciate sacrificing (PS) and an cruciate retaining (CR) PFC knee. The PS design incorporates a polyethylene intercondylar post which compensates for the resected posterior cruciate ligament. This post engages the corresponding femoral component receptacle enabling roll back.
The PFC design was first released in 1996, nearly 1/3 of a million have been implanted. It has a 3.58% cumulative percentage probability of a first revision at 15 years recorded on the NJR, which clearly supports its use. The kit to insert it, is as you will see, is straightforward and the implant has predictable outcomes; features beneficial to both patient and surgeon. This is why I use it.
There are many implant designs on the market, each purporting to be the best. Some incorporate differing radius of femoral curvature, others low contact stresses, others have rotating platforms, others a medial pivot. In my opinion though outcome is as dependant on soft tissue handling, an understanding of knee biomechanics & intra-operative balancing and pre and post operative rehabilitation.
This technique details the posterior cruciate sacrificing PFC (Depuy) total knee replacement.
Author: Andrew Gordon FRCS (Tr & Orth)
Institution: The Northern General Hospital, Sheffield.
Clinicians should seek clarification on whether any implant demonstrated is licensed for use in their own country.