Reserved And Not Retain The Posterior Cruciate Ligament In Total Knee Replacement: A Systematic Review

Objectives: To compare the midterm clinical effect and the clinical application value of the retained or not retained posterior cruciate ligament in total knee arthroplasty.Methods: A computerized search of articles published between 1970 and January 2010 was performed using PUBMED and EMBASE ; a search from the Cochrane Library (Issue 1, 2010).Additionally, a computerized search of articles published between 1978 and January 2010 Chinese Biomedicine Database(CBM) was performed to identify studies comparing the results of retention versus removal of the posterior cruciate ligament(PCL) in total knee replacement. The quality of included studies was critically assessed and data analyses were performed with Cochrane Collaboration's RevMan 5.0.Results:7 literatures were included, which are randomized-controlled -trials (RCT) or quasi-randomized-controlled-trials.Meta analysis showed that:in terms of range of motion of the knee after Total knee arthroplasty, the not retained PCL group are more superior than the retained PCL group[MD=-4.18,95%C(I–7.23,-1.13),P=0.007];in the postoperative clinical scores both groups have no statistically significant difference [MD =- 0.14,95% CI (-1.37,1.10), P = 0.83]; The postoperative functional scores of both groups also have no significant difference[MD =- 3.05, 95% CI (-6.62,0.51), P = 0.09]. P=0.09].The postoperative pain scores have no significant difference between the two groups[RR=0.95,95%CI(–2.40,4.30),P=0.09].Conclusions: In terms of range of motion of the knee after Total knee arthroplasty, the not retained PCL group are more superior than the retained PCL group,but in general, there are no significant difference between the two surgical methods. Overall, due to insufficient existing clinical research sample, the above conclusions requires bigger samples,and a long term follow up of RCT in order to compare the advantages and disadvantages of the two surgical methods.