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Objectives. Because posteriorcruciateligament (PCL) resection makes flexion
gaps wider in total knee replacement (TKR), preserving or sacrificing
a PCL affects the gap equivalence; however, there are no criteria
for the PCL resection that consider gap situations of each knee.
This study aims to investigate gap characteristics of knees and
to consider the criteria for PCL resection. Methods. The extension and flexion gaps were measured, first with the
PCL preserved and subsequently with the PCL removed (in cases in
which posterior substitute components were selected). The PCL preservation
or sacrifice was solely determined by the gap measurement results,
without considering other functions of the PCL such as ‘roll back.’. Results. Wide variations were observed in the extension and flexion gaps.
The flexion gaps were significantly larger than the extension gaps.
Cases with 18 mm or more flexion gap and with larger flexion than
extension gap were implanted with cruciate retaining component.
A posterior substitute component was implanted with the other cases. Conclusions. In order to make adequate gaps, it is important to decide whether
to preserve the PCL based on the intra-operative gap measurements
made with the PCL intact. Cite this article: Bone Joint Res 2014;3:95–100