Objectives: The purpose of this study is to compare the Depuy curved (CVD) polyethylene insert to the curved plus (CVD+) design in TKA, which has an increased dished curve for increased articulation congruence and thus secondary anterior to posterior stability.Methods: A randomized controlled trial with ۱۰۰ patients was conducted to compare two knee replacement designs (CVD and
CVD+ polyethylene inserts) using the Johnson and Johnson DePuy PFC Sigma total knee replacement. All participants, were randomized and blinded to reduce bias. The trial achieved ۱۰۰% recruitment and maintained blinding throughout the study. Demographics, baseline characteristics, and KOOS scores were recorded preoperatively, and at ۳ and ۱۲ months postoperatively. In addition, physical and mental component scores (PCS and MCS) were collected at ۱۲ months post-operatively.Results: Sixty patients had preoperative data, split equally into
CVD and
CVD+ groups. The cohort's average age was ۷۱.۴۷ years, and ۷۲% were female, with no statistically significant demographic differences between groups. Preoperative measures showed no differences in Pain, ADL, or QOL. At ۳ months, no significant differences were noted, though the QOL difference was ۶۴.۴۵ ± ۱۶.۵۷ for
CVD and ۵۲.۹۴ ± ۲۷.۱ for
CVD+ (p = ۰.۱۵). At ۱۲ months, trends favored the
CVD group, but differences in Pain, ADL, QOL, PCS, and MCS were not significant. Complications were similar, except for stiffness, with ۰ cases in the
CVD group and ۳ in the
CVD+ group at ۳ months; both had ۲ additional cases at ۱۲ months.Conclusion: In our study, there was no difference between designs in terms of pain, activities of daily living, and standard outcomes. Further studies are required to support the benefit of increased congruence in the
CVD+ design, even though widespread adoption has been common across the industry. Level of evidence: II
