Intra-operative observations and assessment of knee kinematics (competence and function of PCL, stability throughout the full range of motion, degrees of range of motion) have guided the development of a surgical technique that allow surgeons to plan and perform PCL retaining TKA based on the anatomical integrity of the PCL.
The Tibia is prepared by referencing from the tibial insertion of the PCL rather than the tibial plateau. Trials and implants with different posterior angulation were developed to ease the balance of the flexion gap and reduce the need for soft tissue releases, partial PCL releases or additional tibial cut.