{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T02:17:34Z","timestamp":1774405054507,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,7,2]],"date-time":"2023-07-02T00:00:00Z","timestamp":1688256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,7,2]],"date-time":"2023-07-02T00:00:00Z","timestamp":1688256000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,7,2]],"date-time":"2023-07-02T00:00:00Z","timestamp":1688256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Despite Total Knee Arthroplasty (TKA) being one of the most successful procedures for end stage arthritis, nearly 20% of patients undergoing this procedure remain dissatisfied. Various design options have been introduced to reduce this cohort of patients. One such option has been the introduction of the medial congruent (MC) polyethylene design. This study was undertaken to evaluate outcome measures and gait analysis in patients undergoing bilateral single stage TKA where the posterior cruciate ligament (PCL) was retained or excised in contralateral knees.\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>60 bilateral TKA\u2019s were performed by a single surgeon using a MC design option from July to Sep 2021. The study lots included patients between the ages of 55 and 70 years with fixed varus deformity of degenerative aetiology, and Kellgren Lawrence Grade 3 and 4\u00a0radiological changes. Exclusion criteria were previous surgery to the lower extremities, sero positive arthropathies, post traumatic arthritis, valgus deformity, flexion contractures\u2009&gt;\u200920\u00b0, and any pre\u2010existing pathology impacting gait, e.g., poliomyelitis, or neuromuscular disorders. The PCL was retained or sacrificed on contralateral sides for the purpose of this study. Functional scores, outcomes and gait analysis on level and gradient walking were evaluated at a follow\u2010up of 18\u00a0months.\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 18, months the Range of Motion (ROM) improved from a preoperative value of 97.3\u2009\u00b1\u200911.5 to 110.3\u2009\u00b1\u20096.1 on the PCL retained side (MC\u2010PCL) and from 96.5\u2009\u00b1\u200910.8 to 113\u2009\u00b1\u20095.8 on the PCL excised side (MC\u2010PCLX). Knee Society Score (KSS\u20102011) improved from a preoperative value of 21.2\u2009\u00b1\u20094.5 to 89.8\u2009\u00b1\u20093.4 at 18\u00a0months postoperatively on the MC\u2010PCL side and from 21.5\u2009\u00b1\u20094 to 88.2\u2009\u00b1\u20093.7 on the MC\u2010PCLX side. Forgotten Joint Score (FJS\u201012) was 8.8\u2009\u00b1\u20090.7 on the MC\u2010PCL side and 8.1\u2009\u00b1\u20090.9 on the MC\u2010PCLX side 18\u00a0months after surgery. Our gait analysis evaluation demonstrated a lower forefoot pressure in the MC\u2010PCL group in comparison to the MC\u2010PCLX group when subjects were made to walk on a 30\u00b0 upward incline. This difference was found to be statistically significant.\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, while ROM was greater in the MC\u2010PCLX study lot, patient satisfaction was higher in the MC\u2010PCL study lot. Gait assessment demonstrated lower forefoot pressure while ascending an incline of 30\u00b0 in the MC\u2010PCL study lot as compared to the MC\u2010PCLX study lot approximating normal gait patterns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>II.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-023-07499-5","type":"journal-article","created":{"date-parts":[[2023,7,2]],"date-time":"2023-07-02T10:02:11Z","timestamp":1688292131000},"page":"4741-4746","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["PCL retention demonstrates better functional scores and gait patterns in total knee arthroplasty using a medial congruent insert\u2014a prospective study"],"prefix":"10.1002","volume":"31","author":[{"given":"Ashok","family":"Rajgopal","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Medanta\u2010 The Medicity Hospital 122001 Gurugram Haryana India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumit","family":"Kumar","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Medanta\u2010 The Medicity Hospital 122001 Gurugram Haryana India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish Kumar","family":"Singh","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Medanta\u2010 The Medicity Hospital 122001 Gurugram Haryana India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalpana","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Medanta\u2010 The Medicity Hospital 122001 Gurugram Haryana India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,7,2]]},"reference":[{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010022\u201007033\u2010z"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.4055\/cios20268"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.3928\/0147\u20107447\u201020020901\u201032"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010019\u201004462\u20103"},{"key":"e_1_2_12_6_2","doi-asserted-by":"crossref","unstructured":"Calvisi V Paglia A Ciprietti N Goderecci R (2018) Cruciate retaining total knee arthroplasty. In: Primary Total Knee Arthroplasty. pp 23\u201340","DOI":"10.5772\/intechopen.74024"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/BTO.0000000000000262"},{"issue":"2","key":"e_1_2_12_8_2","first-page":"17","article-title":"Evolution of TKA design","volume":"88","author":"Dall'Oca C","year":"2017","journal-title":"Acta Biomed"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2020.11.003"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS\u2010D\u201020\u201001232"},{"issue":"1","key":"e_1_2_12_11_2","first-page":"154","article-title":"Comparison of plantar pressure distribution between different speed and incline during treadmill jogging","volume":"9","author":"Ho IJ","year":"2010","journal-title":"J Sports Sci Med"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.10.020"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010022\u201007149\u20102"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2014.07.020"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.4055\/cios.2014.6.2.117"},{"key":"e_1_2_12_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010021\u201004054\u20100"},{"key":"e_1_2_12_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.06.035"},{"key":"e_1_2_12_18_2","unstructured":"Parcells B (2017) Native knee kinematics basic concepts of total knee arthroplasty Hip and Knee Book. Elsevier"},{"key":"e_1_2_12_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010022\u201007036\u2010w"},{"key":"e_1_2_12_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201006909\u2010x"},{"key":"e_1_2_12_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/1179544117751431"},{"key":"e_1_2_12_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010022\u201003285\u20100"},{"key":"e_1_2_12_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000023809"},{"key":"e_1_2_12_24_2","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2016.08.41"},{"key":"e_1_2_12_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/os.12895"},{"key":"e_1_2_12_26_2","doi-asserted-by":"publisher","DOI":"10.5792\/ksrr.2014.26.3.135"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-023-07499-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-023-07499-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-023-07499-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-023-07499-5","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T09:50:49Z","timestamp":1760867449000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-023-07499-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,2]]},"references-count":25,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1007\/s00167-023-07499-5"],"URL":"https:\/\/doi.org\/10.1007\/s00167-023-07499-5","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,2]]},"assertion":[{"value":"6 March 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 June 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The corresponding author receives Royalties from Zimmer Biomet and Meril. No other author has any conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the Medanta Institutional Review Board.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was taken from all the patients.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}