ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
More passive internal tibial rotation with posterior cruciate ligament retention than with excision in a medial pivot TKA implanted with unrestricted caliper verified kinematic alignment.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Posterior cruciate ligament management in medial pivot total knee arthroplasty: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2026Pooled it
- What is the "safe zone" for transition of coronal alignment from systematic to a more personalised one in total knee arthroplasty? A systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Pooled it
- PCL retained is safe in medial pivot TKA-a prospective randomized trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Trial
- Retention or sacrifice of posterior cruciate ligament has no effect on in vitro kinematics in medial pivot total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Comparison of Knee Function After Reconstruction With Posterolateral Corner Injury and With or Without Posteromedial Corner Injury for Treating Knee Dislocation Cases: A Prospective Cohort Study.Orthopaedic surgery · 2026Article
- Posterior femoral condylar morphology following mechanical vs. kinematic alignment using a medial-pivot implant designed for mechanical alignment: A CT-based comparative study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Switching From a 6° to a 20° Valgus Prosthetic Trochlear Groove Improved the Forgotten Joint and Oxford Knee Scores After Kinematically Aligned Total Knee Arthroplasty.Arthroplasty today · 2026Article
- Comparable outcomes with a potential functional advantage of PCL preservation in medial-stabilized total knee arthroplasty: A systematic review and meta-analysis from the FP-UCBM Knee Study Group.Journal of experimental orthopaedics · 2025Review
- Clinical outcomes of kinematically aligned medial pivot total knee arthroplasty: A systematic review and meta-analysis of current evidence.Journal of experimental orthopaedics · 2025Review
- No Radiographic Evidence of Medial Collateral Ligament Elongation in Valgus Osteoarthritic Knees Enables Treatment with Kinematically Aligned Total Knee Arthroplasty.The journal of knee surgery · 2025Article
- Medial Congruent and Medial Pivot Inserts in Total Knee Arthroplasty: A Scoping Review.Medicina (Kaunas, Lithuania) · 2025Article
- Article
- An Insert Goniometer Can Help Select the Optimal Insert Thickness When Performing Kinematically Aligned Total Knee Arthroplasty with a Medial 1:1 Ball-in-Socket and Lateral Flat Surface Insert and Posterior Cruciate Ligament Retention.Bioengineering (Basel, Switzerland) · 2024Review
- Retention of the posterior cruciate ligament stabilizes the medial femoral condyle during kneeling using a tibial insert with ball-in-socket medial conformity.International orthopaedics · 2024Article
- Similar Recovery Rate for Patients Aged between 50 and 89 Years That Go Home on the Surgery Day and Self-Administer Their Rehabilitation after Kinematically Aligned Total Knee Arthroplasty.Journal of personalized medicine · 2024Article
- A new tibial insert design with ball-in-socket medial conformity and posterior cruciate ligament retention closely restores native knee tibial rotation after unrestricted kinematic alignment.Journal of experimental orthopaedics · 2023Article
- Ball-in-socket medial conformity with posterior cruciate ligament retention neither limits internal tibial rotation and knee flexion nor lowers clinical outcome scores after unrestricted kinematically aligned total knee arthroplasty.International orthopaedics · 2023Article
- No Significant Differences in Clinical and Radiographic Outcomes between PCL Retained or Sacrificed Kinematic Aligned Medial Pivot Total Knee Arthroplasty in Varus Knee.Journal of clinical medicine · 2022Article
- Application of CT-MRI Fusion-Based Three-Dimensional Reconstruction Technique in the Anatomic Study of Posterior Cruciate Ligament.Orthopaedic surgery · 2022Article
- Measurement of Tibial Orientation Helps Select the Optimal Insert Thickness to Personalize PCL Tension in a Medial Ball-in-Socket TKA.Journal of personalized medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeExcision of the posterior cruciate ligament (PCL) is recommended when implanting a medial pivot (MP) total knee arthroplasty (TKA) to reduce the risk of limiting flexion by over-tensioning the flexion space. The present study determined whether PCL retention (1) limits internal tibial rotation and (2) causes anterior lift-off of the insert in 90° flexion after implantation of an MP design with unrestricted caliper verified kinematic alignment (KA).
methodsFour surgeons implanted an MP TKA design with medial ball-in-socket and lateral flat tibial insert in ten fresh-frozen cadaveric knees. Before and after PCL excision, trial inserts with medial goniometric markings measured the angular I-E tibial orientation relative to the trial femoral component's medial condyle in extension and at 90° flexion, and the surgeon recorded the occurrence of anterior lift-off of the insert at 90° flexion.
resultsPCL retention resulted in greater internal tibial rotation than PCL excision, with mean values of 15° vs 7° degrees from maximum extension to 90° flexion, respectively (p < 0.0007). At 90° flexion, no TKAs with PCL retention and one TKA with PCL excision had anterior lift-off of the insert (N.S.).
conclusionsThis preliminary study of ten cadaveric knees showed that PCL retention restored more passive internal tibial rotation than PCL excision with a negligible risk of anterior lift-off. However, in vivo analysis from multiple authors with a larger sample size is required to recommend PCL retention with an MP TKA design implanted with unrestricted caliper verified KA.
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