SynthesisActa orthopaedica2015
Similar outcome after retention or sacrifice of the posterior cruciate ligament in total knee arthroplasty.
Synthesis in Acta orthopaedica, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Posterior cruciate ligament management in medial pivot total knee arthroplasty: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2026Pooled it
- Posterior Cruciate Ligament Retention versus Posterior Stabilization for Total Knee Arthroplasty: A Meta-Analysis.PloS one · 2016Pooled it
- Effect of Tibial Slope on Knee Mechanics for Posterior Cruciate Ligament Deficient Cruciate-retaining Total Knee Arthroplasty.Arthroplasty today · 2026Article
- Long-term outcomes of single-radius total knee arthroplasty in an Asian population: a comparison of cruciate-retaining and posterior-stabilized designs.Knee surgery & related research · 2026Article
- Comparison of Routine Posterior Cruciate Ligament Resection vs Selective PCL Balancing Using a Medial Congruent Polyethylene in Total Knee Arthroplasty: A Matched-Cohort Analysis.Arthroplasty today · 2026Article
- Posterior-stabilized vs cruciate-retaining TKA in osteoarthritic patients with genu recurvatum: a 2-year comparative analysis.BMC musculoskeletal disorders · 2025Article
- No clinically meaningful differences between PCL preservation and sacrifice in medial pivot total knee arthroplasty: A systematic review and meta-analysis.Journal of experimental orthopaedics · 2025Review
- Pre-operative and Intra-operative Factors Affecting Post-operative Range of Motion in Total Knee Arthroplasty: A Prospective Clinical and Radiological Study.Indian journal of orthopaedics · 2025Article
- On the consequences of intra-operative release versus over-tensioning of the posterior cruciate ligament in total knee arthroplasty.Journal of the Royal Society, Interface · 2024Article
- Article
- Review
- Article
- Posterior-Stabilized Versus Cruciate-Retaining Prostheses for Total Knee Arthroplasty: An Overview of Systematic Reviews and Risk of Bias Considerations.Indian journal of orthopaedics · 2022Review
- [Musculoskeletal multibody dynamics investigation of posterior-stabilized total knee prosthesis].Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi · 2022Article
- Article
- Elongation Patterns of the Posterior Cruciate Ligament after Total Knee Arthroplasty.Journal of clinical medicine · 2020Article
- Effect of surgical parameters on the biomechanical behaviour of bicondylar total knee endoprostheses - A robot-assisted test method based on a musculoskeletal model.Scientific reports · 2019Article
- Higher mid-term revision rates of posterior stabilized compared with cruciate retaining total knee arthroplasties: 133,841 cemented arthroplasties for osteoarthritis in the Netherlands in 2007-2016.Acta orthopaedica · 2018Observational
- Posterior tibial slope impacts intraoperatively measured mid-flexion anteroposterior kinematics during cruciate-retaining total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018Article
- Quality assessment of systematic reviews on total hip or knee arthroplasty using mod-AMSTAR.BMC medical research methodology · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeTo retain or to sacrifice the posterior cruciate ligament (PCL) in total knee arthroplasty (TKA) remains a matter of discussion. In this systematic review, we wanted to find differences in functional and clinical outcome between the 2 methods.
methodsWe conducted a systematic review and meta-analysis including all randomized controlled trials (RCTs) and quasi-RCTs that have compared PCL retention with PCL sacrifice in TKA with a minimum of 1-year follow-up. Primary outcome was range of motion. Secondary outcomes were knee pain and clinical scoring systems that were preferably validated. Quality of evidence was graded using the GRADE approach. All outcomes available for data pooling were used for meta-analysis.
results20 studies involving 1,877 patients and 2,347 knees were included. In meta-analysis, the postoperative flexion angle had a mean difference of 2 degrees (95% CI: 0.23-4.0; p = 0.03) and the KSS functional score was 2.4 points higher in favor of PCL sacrifice (95% CI: 0.41-4.3; p = 0.02). There were no statistically significant differences regarding other measured clinical outcomes such as WOMAC, KSS pain, clinical and overall score, HSS score, SF-12, radiolucencies, femoro-tibial angle, and tibial slope. The quality of the studies varied considerably. Risk of bias in most studies was unclear; 5 were judged to have a low risk of bias and 5 to have a high risk of bias.
interpretationWe found no clinically relevant differences between retention and sacrifice of the PCL in TKA, in terms of functional and clinical outcomes. The quality of the studies ranged from moderate to low. Based on the current evidence, no recommendation can be made as to whether to retain or to sacrifice the PCL.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.