Long-term Results of Partial Release Versus Nonrelease of the Posterior Cruciate Ligament at Cruciate-Retaining Total Knee Arthroplasty: Minimum 15-Year Follow-up

Abstract

The goal of this study was to compare the clinical and radiologic results of posterior cruciate ligament (PCL) partial release and PCL nonrelease in performing cruciate-retaining total knee arthroplasty (CR-TKA) for a long-term follow-up period of greater than 15 years. A total of 224 patients underwent CR-TKA in our hospital from June 1996 to April 2002 with greater than 15 years of follow-up. We divided the subjects into 2 groups based on release of the PCL. Group 1 was the PCL partial release group (88 cases), and group 2 was the PCL nonrelease group (136 cases). The mean follow-up period was 16.8 years (range, 15.5-19.5 years). We compared the clinical results by measuring the Knee Society Score (KSS), Hospital for Special Surgery (HSS) score, and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score preoperatively and at the last follow-up. For radiologic results, the Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System was used and stress radiographs were obtained at the last follow-up to evaluate PCL function. There was no statistically meaningful difference in radiologic and clinical results between the 2 groups. Radiolucent lines were found for 13 patients radiologically (6 in group 1 and 7 in group 2). No instability as a result of PCL insufficiency required revision surgery on stress radiography at the last follow-up. If an appropriate procedure is performed according to PCL function intraoperatively, CR-TKA can produce a satisfactory result on long-term follow-up. [ Orthopedics . 2022;45(4):233–238.]