Assessment of the antero-posterior and rotational stability of the anterior cruciate ligament analogue in a guided motion bi-cruciate stabilized total knee arthroplasty

Abstract

Abnormal knee kinematics and sagittal instability after most knee replacements are due in part to deficient anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) function. The guided motion bi-cruciate stabilized knee replacement aspires to stabilize the knee posteriorly and anteriorly by means of a cam-post mechanism. This investigation studies the ACL-stabilizing function of that mechanism in early flexion, and 25 knees that had undergone replacement with this implant were studied. Antero-posterior laxity at 15 degrees flexion was adequately restored for 76% (16/21) of the knees (side-to-side difference <3 mm on KT assessment), and 72% (18/25) knees exhibited a positive pivot shift test. The findings of this study suggest excellent early clinical outcomes for this implant, but the goal of replicating ACL function has only been partially achieved.

Second-generation bi-cruciate stabilized total knee system has a lower reoperation and revision rate than its predecessor

“…The goal is to provide a “guided motion” which should lead to kinematics similar to that of a normal knee [ 16 – 19 ]. This guided motion has been reported in different studies comparing the JOURNEY™ I BCS prosthesis to other TKA systems and normal knees [ 20 – 25 ]. In vivo fluoroscopic studies demonstrated that nearly normal kinematic motions can be attained with the JOURNEY™ BCS TKS [ 21 , 22 , 24 , 26 – 30 ].…”

Acceleration-based joint stability parameters for total knee arthroplasty that correspond with patient-reported instability

“…More lasting feelings of instability are recorded as lower functional outcome scores on such questionnaires and could occur during every execution of a task. Anterior/posterior (A/P) laxity as determined by a Lachman test (either manual or instrumented with a KT-2000 arthrometer or Rolimeter) varies considerably between different groups of TKA patients, [22][23][24][25] and the use of fluoroscopy has shown paradoxical sliding motions in some activity phases between the femur and the tibia of TKA patients. 26,27 However, research on ACL-deficient knees has shown that passive knee laxity characterized by these tests is not related to knee stability during dynamic activities.…”

Selective Iliotibial Band Release for Iliotibial Band Traction Syndrome After Second-Generation Motion-Guided Bicruciate Stabilizing Total Knee Arthroplasty and Its Rationale: A Case Report With Review of Literature

“…Different concepts (kinematic alignment) and designs (BCSKS/medial pivot knee/bicruciate retaining knee) are evolving to overcome this problem. First-generation dual cam BCSKS was introduced in 2005 to reproduce normal kinematics and accounts for the lack of ACL by creating anterior cam and post [ 6 ]. This is unique from the posterior stabilized knee arthroplasty designs in many aspects (Table 1 ).…”