Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
PCL retained is safe in medial pivot TKA-a prospective randomized trial.
Trial report 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 11 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
11 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
- Alignment strategy does not confer clinically meaningful advantages in medial pivot total knee arthroplasty: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2026Pooled it
- Superior Sensitivity of the Forgotten Joint Score in Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials.Arthroplasty today · 2026Article
- Mid-term outcomes of a novel liner design in kinematically-designed cruciate-retaining total knee arthroplasty.World journal of orthopedics · 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
- 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
- Medial Congruent and Medial Pivot Inserts in Total Knee Arthroplasty: A Scoping Review.Medicina (Kaunas, Lithuania) · 2025Article
- No difference in clinical outcomes when retaining or sacrificing the posterior cruciate ligament in medial congruent total knee replacement. A retrospective study.Musculoskeletal surgery · 2025Article
- The Orientation of the Prosthetic Trochlear Angle Is Predictable in Kinematically Aligned Total Knee Arthroplasty.Journal of personalized medicine · 2025Article
- Mapping the reporting practices in recent randomised controlled trials published inJournal of experimental orthopaedics · 2025Article
- Autogenous structural bone graft reconstruction of ≥ 10-mm-deep uncontained medial proximal tibial defects in primary total knee arthroplasty.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMedial pivot (MP) designs resemble native knee kinematics and restore the "natural" kinematics of a knee after total knee arthroplasty (TKA). However, whether to preserve or resect the posterior cruciate ligament (PCL) is still under debate. We inquired whether sacrificing the PCL would improve range of motion, functional outcomes, and limb alignment compared to preserving the PCL in TKA using medial pivot implants (MP-TKA).
methodsThis prospective, double-blinded, randomized controlled trial consisted of 33 patients (66 knees) undergoing bilateral simultaneous MP-TKA. In one knee, a PCL preservation technique was performed, and in the contralateral knee, the PCL was resected. The primary outcome was postoperative range of motion (ROM). The secondary outcomes were visual analogue scale (VAS) score for knee pain at walking, Knee Injury and Osteoarthritis Outcome Score for symptoms (KOOS-S) and quality of life (KOOS-QoL), Oxford knee score (OKS), and Forgotten Joint Score (FJS), and measurement of the mechanical femoral-tibial axis (mFTA) on X-ray images. All patients were followed up for a minimum of 2 years after surgery.
resultsPatients who underwent MP-TKA with PCL preservation had a similar ROM at 2 years (125.45 ± 7.00 vs. 126.21 ± 6.73, p = 0.65) as those who underwent MP-TKAs with PCL resection. There was also no difference in VAS score (1.94 ± 0.79 vs. 2.00 ± 0.71, respectively, p = 0.51), OKS (39.97 ± 2.01 vs. 39.67 ± 2.03, respectively, p = 0.52), KOOS-S (84.41 ± 3.77 vs. 84.19 ± 3.57, respectively, p = 0.92), KOOS-QoL (82.94 ± 4.76 vs. 82.75 ± 4.70, respectively, p = 0.84), or FJS (72.66 ± 8.99 vs. 72.35 ± 8.64, respectively, p = 0.76) at the 2-year follow-up. No difference in the measurement of the mFTA was found between the two groups (180.27 ± 2.25 vs. 181.30 ± 2.13, respectively, p = 0.59).
conclusionThis study demonstrated that both medial pivot TKA with PCL preservation and PCL resection achieved excellent results. There was no difference at the 2-year follow-up in terms of postoperative ROM, patient-reported outcomes, or radiographic evaluation. LEVEL OF EVIDENCE: Therapeutic study, Level I.
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