{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:50:35Z","timestamp":1792083035128,"version":"4.4.0"},"reference-count":68,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":33,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The debate on whether to preserve or sacrifice the posterior cruciate ligament (PCL) during medial congruent (MC) total knee arthroplasty (TKA) is still ongoing. Currently, there is no comprehensive consensus due to the limited evidence on which approach yields better outcomes. This systematic review and meta\u2010analysis aimed to compared the functional outcomes of PCL retaining (PR) versus PCL sacrificing (PS) in MC TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Two independent researchers to find relevant articles, with no time limit until 4 August 2025, searched PubMed\/Medline, Scopus, Web of Science and Embase databases. Postoperative functional outcomes were compared between the PR and PS groups, in accordance with preferred reporting items for systematic reviews and meta\u2010analyses guidelines. The Cochran\n                      <jats:italic>Q<\/jats:italic>\n                      and\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      tests were employed to assess heterogeneity between studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six cohort studies, including 903 patients, were included. The pooled estimate of the four studies demonstrated that at 3 months after surgery, the mean difference in postoperative KSS score between the PR and PS groups was 1.15, which was not statistically significant (95% CI: \u20131.11, 3.31). At 12 months after surgery, the mean Knee Society Score (KSS) reached statistical significance in favour of the PR group (MD: 1.97,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05); however, this difference did not exceed the minimal clinically important difference (MCID) of 5.3 points, indicating a lack of clinical significance There was no significant difference in the mean Oxford Knee Score (OKS) score at 3 and 12 months after surgery between the PR and PS groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There appears to be no clinically meaningful difference in PR or PS during MC TKA in improving short\u2010term clinical outcomes based on moderate\u2010certainty evidence (Level IV). In the long term, preserving the PCL may lead to greater improvements in physical function compared to losing the PCL. However, no significant differences were noted in other clinical or functional outcomes, nor in complication rates, between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70873","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:34:58Z","timestamp":1785771298000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of preservation versus sacrifice of the posterior cruciate ligament on clinical outcomes after medial congruent total knee arthroplasty using mechanical alignment: A systematic review and 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Orthopedic Surgery Urmia University of Medical Sciences Urmia Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajad","family":"Fakoor","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Faculty of Medicine Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1675845"},{"issue":"1","key":"e_1_2_12_3_1","first-page":"6","article-title":"Medial pivot knee in primary total knee arthroplasty","volume":"4","author":"Atzori F","year":"2016","journal-title":"Ann Transl 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