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Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 9 Issue 1

Comparison of Routine PCL Resection Versus Selective PCL Balancing Using a Medial Congruent Polyethylene in Total Knee Arthroplasty: A Matched-Cohort Analysis

Jacob Goldstein1, Sara Strecker2*, Donald Allen2,3 and Dan Witmer2,3

1University of Connecticut School of Medicine, Farmington CT, USA
2Bone and Joint Institute, Hartford Healthcare, Hartford CT, USA
3Orthopedic Associates of Hartford, Hartford CT, USA

*Corresponding Author: Sara Strecker, Bone and Joint Institute, Hartford Healthcare, Hartford CT, USA.

Received: October 21, 2025; Published: December 03, 2025

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Abstract

Background: Total knee arthroplasty (TKA) techniques and implant designs vary significantly regarding management of the posterior cruciate ligament (PCL). The clinical implications of routinely resecting or selectively balancing the PCL in modern congruent or pivot designs remain debated. This study compares clinical outcomes between routine PCL resection and selective PCL balancing using a medial congruent (MC) polyethylene.

Methods: A retrospective matched-cohort study was conducted with 304 patients undergoing primary unilateral TKA between September 2020 and April 2024. Patients were matched based on demographics (age, gender, BMI, Charlson Comorbidity Index (CCI), The Risk Assessment and Prediction Tool (RAPT) score) and based on preoperative Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR) scores. Postoperative outcomes were analyzed including patient-reported outcome measures, physical therapy parameters, readmission rate, overall complication rate and 90 day return to operating room.

Results: The PCL resection group had significantly longer operative times (86.5 vs. 73.9 minutes, p<0.001) but lower all-cause 90-day readmission rates (1.3% vs 5.9% p = 0.032). No significant differences were observed in KOOS JR, PROMIS scores, Forgotten Joint Score, postoperative pain levels, physical therapy parameters, or discharge disposition.

Conclusion: Routine PCL resection in TKA utilizing a medial congruent polyethylene design did not influence patient-reported outcomes compared to selective balancing and should be left up to surgeon preference.

Keywords: Total Knee Arthroplasty; Posterior Cruciate Ligament; Medial Congruent Polyethylene; Patient-Reported Outcomes; Matched-cohort Analysis

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Citation

Citation: Sara Strecker., et al. “Comparison of Routine PCL Resection Versus Selective PCL Balancing Using a Medial Congruent Polyethylene in Total Knee Arthroplasty: A Matched-Cohort Analysis".Acta Scientific Orthopaedics 9.1 (2026): 04-10.

Copyright

Copyright: © 2026 Sara Strecker., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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    Authors are requested to submit manuscripts on/before January 05, 2025, for the Second issue of 2026.

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