Arthroscopic release of the posterior cruciate ligament for stiff total knee arthroplasty

Ten posterior cruciate ligament sparing total knee arthroplasties were studied in 9 patients who underwent arthroscopic posterior cruciate ligament release to improve intractable postoperative knee stiffness and pain. Mean patient age was 64 years. Before posterior cruciate ligament release, the mean knee extension was 4 degrees (0 degrees - 10 degrees); mean knee flexion was 73.9 degrees (40 degrees - 110 degrees). The mean interval to posterior cruciate ligament release after primary total knee arthroplasty was 29 months. After release, mean extension was 1.3 degrees (0 degrees - 10 degrees) and mean flexion was 112 degrees (range, 85 degrees - 135 degrees). The average increase in flexion observed in the immediate postoperative period was 40.1 degrees (25 degrees - 60 degrees). At a mean followup of 20 months, mean extension was 1.5 degrees (0 degrees - 10 degrees), and mean flexion was 104.5 degrees (70 degrees - 125 degrees). At followup, the average increase in knee flexion was 30.5 degrees (10 degrees - 50 degrees). Before arthroscopic posterior cruciate ligament release, the average Knee Society knee and function scores were 70.9 and 71, respectively. At followup, the average Knee Society knee and function scores were 86.4 and 88, respectively. The Knee Society pain score improved from 33.5 preoperatively to 42 postoperatively. All patients reported subjective improvements in pain and stiffness. Eight patients (88%) reported satisfaction with the procedure. Two patients (22%) eventually required revision total knee arthroplasty.