title: Is the effect of a posterior cruciate ligament resection in total knee arthroplasty predictable?
abstract: OBJECTIVE
  It is broadly supposed that in total knee arthroplasty, the flexion/extension gap ratio is increased after resection of the posterior cruciate ligament (PCL). However, studies are rare and results are inconsistent. Therefore, this study was conducted to determine whether PCL release regularly increases the flexion gap.
  
  
  METHODS
  Data from 50 consecutive posterior stabilised knee prostheses were analysed retrospectively. Using imageless computer navigation, the joint-gap width was measured over the entire range of motion before and after PCL release.
  
  
  RESULTS
  PCL release had no effect on the extension gap, but it increased the flexion gap significantly. An increase of >3 mm occurred in 36% of patients and of >5 mm in 12%. No clinically relevant effect (<2 mm) was found in 44% of patients.
  
  
  CONCLUSIONS
  PCL release increased the flexion/extension gap ratio on average, but the individual effect could not be predicted. Therefore, we recommend PCL release before the femoral resections are performed, as this step mainly determines the ratio between extension and flexion gap.
authors.affiliation: LVR Klinik für Orthopädie Viersen, Horionstrasse 2, 41749 Viersen, Germany. christophschnurr@gmx.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Schnurr
authors.forename: Peer
authors.initials: P
authors.lastname: Eysel
authors.forename: Dietmar P
authors.initials: DP
authors.lastname: König
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D016059:Range of Motion, Articular; D025321:Surgery, Computer-Assisted / Q000009:adverse effects; D016896:Treatment Outcome