Abstract
Purpose: The purpose of this study was to evaluate the change in posterior cruciate ligament (PCL) tension by directly measuring the pressure changes in the knee joint when the ligament was released or resected during total knee arthroplasty (TKA).Methods: We prospectively analysed 22 patients who underwent primary TKA (28 knees) between October 2019 and January 2020. The pressure changes in the medial and lateral compartment were measured with an electronic pressure sensor with PCL retention (at 0°, 45°, 90° and 120° of flexion), tibial recession and PCL resection, and changes in the knee joint space were measured.Results: At 0°, 45°, 90° and 120° of flexion, the total pressure in the knee joint after tibial recession of the PCL was significantly higher than with PCL resection, and higher than PCL recession, but only at 120°. Recession or resection of the PCL affected knee joint extension, and the medial/lateral pressure in the knee joint decreased. Pressure in the lateral compartment showed no significant change, while pressure in the medial compartment decreased significantly during knee flexion, which also led to a change in the ratios of the medial and lateral pressures in the knee joint. After resecting the PCL, the mean flexion and extension gaps increased by 0.64 mm and 0.46 mm, respectively.Conclusion: Tibial recession of the PCL can release the PCL while retaining some PCL function. PCL release affects both the flexion and extension gaps, and more cases will increase the flexion gap.