Deep Dish Total Knee Arthroplasty -Is It a Myth or Reality?

Background: Total Knee Arthroplasty (TKA) remains the gold standard for managing severe knee degenerative diseases, offering signicant relief from pain and improved functionality. However, challenges persist in optimizing outcomes, particularly regarding the management of the Posterior Cruciate Ligament (PCL) during surgery. While traditional approaches involve substituting the PCL with post-cam mechanisms, concerns over bone integrity and stability have prompted exploration into alternative methods, such as ultra-congruent deep dished polyethylene inserts. This prospective study evaluated 20 patients who underwent primary TKA using a highly confo Materials and Methods: rming deep dished polyethylene insert following PCL resection. Surgical techniques included the medial parapatellar approach and precise component xation with cement. Pre-operative and post-operative Knee Society Score (KSS) and Functional Score (FS) were compared, and statistical analyses were conducted to assess correlations between various factors. : The study demonstrated signicant improv Results and Discussion ements in pain relief, functional ability, and knee stability postoperatively. Notably, there were no instances of anteroposterior instability observed, and the risk of supracondylar femur fracture was mitigated due to the elimination of bone resection. Furthermore, the deep dished polyethylene insert exhibited a lower rate of wear and tear compared to alternative designs, contributing to enhanced durability. Comparative analyses with existing literature support the efcacy of this approach, particularly in optimizing knee stability and range of motion. In conclusion, posterior Conclusion: substituting total knee replacement using ultra-congruent deep dished polyethylene inserts offers a promising avenue for effectively addressing knee degenerative diseases. However, careful patient selection is crucial, as this approach may not be suitable for morbidly obese patients or those with gross xed exion and varus deformity. Future studies with larger cohorts and longer follow-up periods are warranted to validate these ndings and rene surgical techniques in TKA.