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Stress analysis after total knee arthroplasty with posterior cruciate ligament-resection type and -retention type prosthesis--with special reference to the significance of retaining the posterior cruciate ligament.

Stress analyses in knees replaced with PCL-resection type and PCL-retention type prosthesis under various loading conditions were performed by means of the three-dimensional finite element method. In the knee replaced with the PCL-resection type prosthesis, distribution of large transmitted loads was concentrated in a small area located in front of the stem and under the plateau of prosthesis. The sum of moments of transmitted loads increased as horizontal component loads on the femoral component increased. Large von Mises stresses were distributed in the anterior and proximal parts of the tibia. In the tibia replaced with the PCL-retention type, transmitted loads were observed in the whole area under the plateau and posterior cortex. The sum of moments was significantly smaller than that in the PCL-resection type. Large von Mises stresses were distributed in the posterior and proximal parts of the tibia. It was recommended that the PCL be saved in total knee arthroplasty whenever possible.

Biomechanical Phenomena↗