Introduction: The Posterior Cruciate Referencing Technique (PCRT) for total knee arthroplasty (TKA) uses innovative instrumentation and tibial inserts with varying posterior slopes, and is designed to maximize motion and stability in cruciate-retaining knees, while preserving bone and ligament integrity. This study evaluated early clinical results for this technique.

Methods: An IRB-approved, retrospective, single-site, single-surgeon study was conducted in 2009. 50 patients were put into two groups: Group 1 included patients undergoing CR TKA using standard technique and implants and Group 2 included patients undergoing CR TKA using PCRT. Demographics, surgical time, length of stay (LOS), range of motion, and Oxford Knee Scores (OKS) were collected.

Results: Data sets were complete on 41 patients. Follow-up averaged 14 months for Group 1 and nine months for group 2. Both groups had a mean age of 66.4, were 51% female, and had an average BMI of 30.6. LOS was 1.25 days for Group 1 and 1 day for Group2 (p=0.011). Surgical time was 48 minutes for Group 1 and 46 minutes for Group 2 (p=0.184). Average flexion was 118° for Group 1 and 123° for Group 2 (p=0.073). OK S were 92–94% good and excellent with a mean of 20.4 for both groups.

Conclusions: The learning curve for PCRT and the associated instrumentation and implants did not adversely affect clinical results. Instead, the data indicated a small savings in surgical time and a moderate, but not statistically significant, increase in flexion. LOS, however, was significantly shortened. PCRT may allow for better PCL function while preserving bone and reducing surgical manipulation, and with tibial inserts of varying posterior slopes may improve flexion, stability, and function in CR TKA. Further study is warranted.