Cruciate Sacrificing & Posterior Stabilized Total Knee Repla
The use of highly conforming polyethylene tibial-inserts in contemporary cruciate-retaining (CR) TKR often requires PCL release/sacrifice for balancing (CS TKR). The CS TKR relies on the posterior capsule, collateral ligaments, and articular conformity without a cam or post to achieve stability. Using prospectively collected data, researchers compared clinical outcomes of CS TKR to posterior-stabilized (PS) TKR utilizing a contemporary TKR system.

69 consecutive CS TKRs were compared to 45 consecutive PS TKRs at 2-year minimum follow-up. CS knees were balanced with the PCL released. Pre/postoperative range of motion (ROM), knee society scores (KSS), stair function, and squatting ROM were analyzed.

--At minimum 2-year follow up, CS and PS TKR demonstrated significant improvement in ROM, and KSS, and KSS stair function, with no revisions.

--There was no difference in preoperative to postoperative improvements for passive knee ROM (10 vs 13), KSS Pain (34 vs. 38), KSS Function (35 vs. 35), and KSS stair function (10 vs. 10) for CS and PS TKR, respectively.

--CS TKR had higher squatting ROM at minimum 2-year follow up compared to PS TKR.

In particular, both PS and CS TKR improved clinical outcomes significantly, with no differences in passive ROM, KSS, or stair function after surgery. This evidence suggests that CR TKR in a PCL-deficient knee (CS TKR) is feasible with optimal articular conformity and balance.