Joint distraction force changes the three-dimensional articulation of the femur and tibia in total knee arthroplasty: a cadaveric study.

Joint distraction force changed three-dimensional articulation regardless of PCL preservation. PCL function was revealed as a factor restraining both tibial posterior translation and internal rotation. Surgeons should recognize that joint gap evaluation using a tensor device is subject to three-dimensional changes depending on the magnitude of the joint distraction force.