Semimembranosus Release Reduces Tibial Internal Rotation and Flexion Angle in Cruciate-Retaining Total Knee Arthroplasty

Medial release for varus knee is a key procedure to obtain appropriate soft tissue balance in total knee arthroplasty (TKA). The influence of semimembranosus release during cruciate-retaining (CR) TKA on knee kinematics and clinical outcomes were investigated in consecutive 50 patients (25: semimembranosus release group, 25: minimum release group) with moderate varus osteoarthritis using a navigation system. Semimembranosus release significantly reduced the amount of tibial internal rotation before bone cut and after all prostheses implanted. Despite of no significant differences in clinical scores between the groups, minimum release group exhibited significantly higher postoperative flexion angle compared to the semimembranosus release group. Minimal medial release with avoiding semimembranosus release maintains tibial internal rotation in CR TKA, resulting in achievement of postoperative high flexion angle.