The role of the posterior cruciate ligament in total knee replacement

Total knee replacement (TKR) is a successful and reproducible operation with good long-term prosthesis survivorship and good or excellent functional outcomes: over 95% at 10 years. TKR is presently indicated also for younger patients (<55 years) suffering from rheumatoid arthritis, as well as posttraumatic and idiopathic arthritis. However, some controversies remain concerning surgical techniques. To date there has been no clear evidence that would indicate how best to deal with the posterior cruciate ligament at the time of TKR. The present study is a review of the latest literature, comparing kinematics, proprioception, range of motion, gait pattern, polyethylene wear, and survivorship of posterior stabilized and cruciate retaining knee prostheses.