Rollback in posterior cruciate ligament—retaining total knee arthroplasty

Effects of A-P translation and rotation on the wear of UHMWPE in a total knee joint simulator

“…This movement has been reported for several types of PCL-retaining TKR. [11][12][13] For Exp. 4, the tibial A-P translation was added at +12 mm, now simulating physiological femoral "roll-back" posteriorly.…”

“…With flexion, a normal knee shows posterior shift of the femoral condyle (rollback), in which both rolling and sliding motions are involved, whereas anterior shifts of the femoral condyle with knee flexion have been observed in some posterior-cruciate-ligament (PCL)-retaining TKRs. [11][12][13] Thus, the sliding motion is dominant in those knees. Furthermore, several reports have shown that the distance of anterier-posterior (A-P) translation of TKR patients or anterior cruciate ligament deficient patients is longer than in normal knees.…”

Three-Dimensional Tibiofemoral Articular Contact Kinematics of a Cruciate-Retaining Total Knee Arthroplasty

“…any investigators have studied in vivo knee kinematics after total knee arthroplasty and have reported inconsistent in vivo motion data [1][2][3][4][5][6][7][8][9] . Matsuda et al 7 measured the anteroposterior laxity of a posterior cruciate ligament-retaining total knee replacement (Miller-Galante I; Zimmer, Warsaw, Indiana) in nineteen knees with use of a KT2000 arthrometer (MEDmetric, San Diego, California) and found inconsistent anteroposterior stability in flexion.…”

Soft Tissue Balance in Total Knee Arthroplasty

“…When we consider flexion gap tightness, Ritter et al reported that 30% of CR TKA required ligament balancing to obtain a smooth flexion arc [90]. If the PCL was too tight, excessive femoral rollback resulted in anterior lift-off of the tibial trial in flexion, leading to a limitation of flexion [91]. To make a better post-operative flexion angle, balancing the flexion gap can result in a satisfactory range of motion [92,93].…”

“…Similarly, using a commercially available knee balancer with the measurement under 80 N distraction force, Higuchi et al reported flexion medial/lateral gap tightness led to restriction of the flexion angle [94]. Therefore, in these cases, surgeons are advised to avoid flexion gap tightness by soft tissue release such as PCL [90,91,95].…”