BACKGROUND: Improving outcomes has driven advancements in total knee arthroplasty (TKA) bearing design. The aim of this study was to compare medial-congruent (MC), ultracongruent (UC), and cruciate-retaining (CR) TKA utilizing a single CR total knee system. METHODS: Six surgeons performed 2883 primary TKAs from 2012 to 2022 using the same implant design, comprised of 708 MC, 799 UC, and 1376 CR bearings. Prospectively collected data on clinical and patient-reported outcome measures were compared. Data analyses utilized analysis of variance tests for continuous data, RESULTS: All groups experienced similar rates of 90-day complications (MC = 26/708, 3.7% vs UC = 39/799, 4.9% vs CR = 52/1376, 3.8%
CONCLUSIONS: No differences in all-cause complications or revisions were observed for MC, UC, and CR bearings using the same total knee system. Clinically important differences favoring MC bearings were found with Patient-Reported Outcomes Measurement Information System Global Health Physical scores at 1 year
however, longer follow-up is necessary to determine if this trend holds.