Abstract:

Introduction: Proper ligament tension in flexion with posterior cruciate retaining (CR) total knee arthroplasty (TKA) has long been associated with clinical success. The purpose of this study was to determine the effect of varying levels of posterior cruciate ligament (PCL) release on the tibiofemoral kinematics and PCL strain.
Materials and Methods: A computational analysis was performed and varying levels of PCL release were simulated. Tibiofemoral kinematics was evaluated. The maximum PCL strain was determined for each bundle to evaluate the risk of rupture based on the failure strain.
Results: The femoral AP position shifted anteriorly as the PCL stiffness was reduced. PCL strain in both bundles increased as stiffness was reduced. The model predicts that the AL bundle should not rupture for a 75% release. Risk of PM bundle rupture is greater than AL bundle.
Discussion: Our findings suggest that a partial PCL release impacts tibiofemoral kinematics and ligament tension and strain. The relationship is dynamic and care should be taken when seeking optimal balance intra-operatively.

Authors:

Ran Schwarzkopf, MD, MSc, Assistant Professor, Department of Orthopaedic Surgery, Division of Adult Reconstruction, NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, NY, Scott K. Laster, BSc, Director of Knee Marketing and, Active Knee Business Leader, Smith & Nephew, Memphis, TN, Michael B. Cross, MD, Assistant Professor, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, Nathaniel M. Lenz, MSc, Product Development Engineer, Smith & Nephew Memphis, TN

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