Rationale of Cruciate Retaining Design in Rheumatoid Arthritis: A Review of Clinical Analysis and its Role in Rheumatoid Arthritis

Munis Ashraf *, Om Prakash Sharma, Sruthi Priyavadhana, Senthil Nathan Sambandam, Varatharaj Mounasamy
Department of Orthopedic Surgery, KG Hospital and Post Graduate Medical Institute. Coimbatore, Tamil Nadu, India

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 2291
Abstract HTML Views: 1352
PDF Downloads: 600
ePub Downloads: 465
Total Views/Downloads: 4708
Unique Statistics:

Full-Text HTML Views: 1210
Abstract HTML Views: 795
PDF Downloads: 286
ePub Downloads: 216
Total Views/Downloads: 2507

Creative Commons License
© 2017 Ashraf et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Orthopedic Surgery,KG Hospital and Post Graduate Medical Institute. Coimbatore, Tamil Nadu, India; Tel: 009142222121, Email:



Over the years, proponents of total knee designs (cruciate retaining and posterior stabilised) have conducted several long-term studies to claim the potential of these designs in several subsets of patients. Total knee arthroplasty (TKA) in patients with rheumatoid arthritis has also been one such domain where numerous studies were conducted in the past. A general perception among majority of arthroplasty surgeons is that, posterior stabilised (PS) is the implanted design of choice among patients with Rheumatoid arthritis (RA). However, with the available literature there is a significant disparity related to the selection of implants in patients with rheumatoid RA. In this review of literature, an attempt is made to identify the clinical performance and role of one such implant design, the cruciate retaining (CR) prosthesis in rheumatoid arthritis.


The review was conducted after a series of advanced search in the following medical databases; Pub med, Biomed central, Cochrane and Google scholar for articles related to long term follow up studies of cruciate retaining total knee arthroplasty in rheumatoid arthritis using the keywords cruciate retaining prosthesis, total knee arthroplasty, rheumatoid arthritis.


The available data demonstrate that the CR design is attributed with an excellent long term survivorship and functional outcome even in follow up studies up to twenty-five years.


The advantages of using a CR design are long term survivorship, controlled femoral roll back and preservation of bone stock. Thus, the data gathered in this review lead to a consideration that the CR design is an implant design on par with PS design in patients with RA.

Keywords: Rheumatoid arthritis, Cruciate retaining, Posterior Stabilised, Total Knee Arthroplasty, Survivorship, Functional Outcome.