Continued preservation or replacement of the posterior cruciate ligament is under debate. In total knee replacement, the availability of a cemented condylar ligament donor, a ligament substitute, and ligament preservation have all resulted in excellent long-term outcomes, perpetuating the debate. The debate centers on whether preservation of the PCL actually enhances posterior femoral roll when the knee is flexed. A theoretical topic and clinical evaluation of knee arthroplasty are helpful in resolving this debate. Important new information from the fields of biomechanics, histology, gait analysis, imaging, and the operating room has fueled the discussion about the PCL. Interested readers will find a review that extensively explores these topics. The potential advantages of PCL retention have been demonstrated by the directors to include: joint line . Posterior femoral roll . Maintenance of proprioception, maintenance of the articular center contact point and low shear stresses between the cemented surfaces of the tibial components.The disadvantages of PCL retention are the high stresses of polyethylene, which interfere with femoral sliding, and the difficulty of balancing the soft tissues.