The Fate of the PCL in Cruciate Retaining TKA A Critical Review of Surgical Technique

Abstract

This study prospectively reviews 368 consecutive primary TKA’s, documenting the status of the PCL during 3 stages of the TKA procedure: 1) at initial arthrotomy, 2) after all bone cuts were made, and 3) after final balancing with all components in place. We found at initial presentation that 94% of PCL’s were intact. After the bone cuts were made only 51% of PCL’s remained intact. Finally, after knee balancing and all implants were in place, only 33% of PCL’s remained intact. Furthermore, 43% of PCL’s were attenuated at the final evaluation stage and were at risk for late PCL stretch-out. In this series, patients with a deficient or attenuated PCL were treated with an anterior stabilized bearing that could be utilized with a cruciate retaining femoral component. We advocate that a cruciate substituting bearing be routinely available when undertaking a cruciate retaining TKA. Key words: TKA, CR TKA, PCL, ACL, Anterior Stabilized, Primary Level of Evidence: AAOS Therapeutic Study Level III