To assess the effects of a posterior cruciate ligament resection on the tibiofemoral joint gap in total knee arthroplasty.

The effect of a PCL resection on the tibiofemoral joint gap was analyzed prospectively in 58 patients (69 knees) who had undergone TKA between May 2003 and April 2006. The knee was exposed using a modified subvastus approach. The medial soft tissue was released and a tibial cutting was made first. The tibial insertion of a PCL was protected during the tibial resection by inserting a thin osteotome in front of the posterior spine. An extension and flexion gap were measured using a balancer/tensor device (Stryker Howmedica Osteonics®, Allendale, NJ, USA) under manual maximal stress before and after the PCL resection. The change of the joint line and the posterior inclination on preoperative and postoperative lateral roentgenograms was also assessed.

After the PCL resection, the flexion gap and extension gap increased by an average of 3.6±1.5 mm and 2.0±1.0 mm, respectively. Although the PCL resection resulted in an increasing a flexion gap and extension gap, the increase in the flexion gap was larger than that of the extension gap by 1.6 mm.

A PCL resection resulted in an increase in the flexion and extension gaps by 3.6 mm and 2.0 mm, respectively. Therefore, a PCL resection would be a good alternative method for controlling the flexion-extension gap in TKA.