PURPOSE: Based on the anatomy of the tibial PCL insertion site, we hypothesized that at least part of it is damaged while performing a standard tibial cut in a PCL-retaining total knee replacement. The purpose of this study was to determine and quantify the amount of resection of the tibial PCL attachment with a 9 mm tibial cut with 3 degrees of posterior slope. METHODS: Twenty cadaver tibias were used. The borders of the PCL footprint were demarcated, and calibrated digital pictures were taken in order to determine the surface area. A standard tibial intramedullary guide was used to prepare and perform a tibial cut at a depth of 9 mm with 3 degrees posterior slope. After the tibial cut was made, a second digital picture was taken using the same methodology to measure the surface area of the remaining PCL insertion. RESULTS: The mean surface area of the intact tibial PCL footprint before the cut was 148.9 ± 25.8 mm(2) and after the tibial cut 47.1 ± 28.0 mm(2). On average, 68.8 ± 15.3 % of the surface area of the PCL insertion was removed. CONCLUSION: The results of this study, therefore, indicate that the conventional technique for tibial preparation in cruciate-retaining total knee arthroplasty can result in damage or removal of a significant part of the tibial PCL insertion.
PURPOSE: Based on the anatomy of the tibial PCL insertion site, we hypothesized that at least part of it is damaged while performing a standard tibial cut in a PCL-retaining total knee replacement. The purpose of this study was to determine and quantify the amount of resection of the tibial PCL attachment with a 9 mm tibial cut with 3 degrees of posterior slope. METHODS: Twenty cadaver tibias were used. The borders of the PCL footprint were demarcated, and calibrated digital pictures were taken in order to determine the surface area. A standard tibial intramedullary guide was used to prepare and perform a tibial cut at a depth of 9 mm with 3 degrees posterior slope. After the tibial cut was made, a second digital picture was taken using the same methodology to measure the surface area of the remaining PCL insertion. RESULTS: The mean surface area of the intact tibial PCL footprint before the cut was 148.9 ± 25.8 mm(2) and after the tibial cut 47.1 ± 28.0 mm(2). On average, 68.8 ± 15.3 % of the surface area of the PCL insertion was removed. CONCLUSION: The results of this study, therefore, indicate that the conventional technique for tibial preparation in cruciate-retaining total knee arthroplasty can result in damage or removal of a significant part of the tibial PCL insertion.
Authors: A A Bolanos; W A Colizza; P D McCann; R S Gotlin; M E Wootten; B A Kahn; J N Insall Journal: J Arthroplasty Date: 1998-12 Impact factor: 4.757
Authors: Adam J Schwartz; Craig J Della Valle; Aaron G Rosenberg; Joshua J Jacobs; Richard A Berger; Jorge O Galante Journal: Clin Orthop Relat Res Date: 2010-05-04 Impact factor: 4.176
Authors: A Notarnicola; G Maccagnano; A Fiore; A Spinarelli; L Montenegro; M Paoloni; F Pastore; S Tafuri; B Moretti Journal: Musculoskelet Surg Date: 2017-10-03
Authors: G J P Geijsen; P J C Heesterbeek; G van Stralen; P G Anderson; A B Wymenga Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-05-16 Impact factor: 4.342