The Orthobullets Podcast Podiums | Knee & Sports | What Do We Know About all the Liner Options without a Post in the Setting of PCL Sacrifice? A Current Review
Dec 6, 2025
Dr. Michael Bolognese, an acclaimed orthopaedic surgeon specializing in knee arthroplasty, delves into innovative non-post liner options while sacrificing the PCL. He explains the rationale for this approach and highlights the history behind ultra-congruent liners, showcasing their impressive performance compared to traditional designs. Bolognese discusses the unique kinematics of medial pivot designs and the benefits of combining these with kinematic alignment. With insightful evidence, he presents the trends favoring these innovative options in modern knee surgery.
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Ultra-Congruent Liners Work Without A Post
- Ultra-congruent (UC) liners provide acceptable kinematics and have decades of predictable use without a post.
- Michael Bolognese reports UC liners perform comparably to posterior-stabilized (PS) designs in many studies.
Real Case Sparked UC Development
- Aaron Hoffman developed a conforming bearing after a real-world case where a patient had PCL failure but he wanted to avoid full revision.
- That clinical problem directly motivated the early ultra-congruent prototype described by Michael Bolognese.
Evidence Supports UC Comparable To PS/CR
- Multiple studies show UC liners have similar survivorship and PROMs compared to PS and CR designs.
- Michael Bolognese cites specific papers reporting no clear superiority of PS over UC and some better PROMs with UC.