Bicruciate-retaining total knee arthroplasty, a promising technology, that’s not quite there

Barrett, Thomas J.; Shi, Lei; Parsley, Brian S.

doi:10.21037/atm.2017.03.77

Cited by 10 publications

(2 citation statements)

References 7 publications

(4 reference statements)

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“…25 The design of BCR TKA aims to preserve both ACL and PCL which demands a higher level of attention to the accurate and precise component orientations in order to optimally restore the native knee biomechanics. 26 To our knowledge, our study is one of the first to describe 3D component orientation in BCR TKA. Although currently, there is no consensus on the "ideal" BCR TKA component orientations, the large variability observed in the axial and sagittal alignment of the tibial component provides clinically useful information for surgeons in optimizing BCR TKA component orientations, such as the need for the use of additional surgical navigation guides.…”

Section: Discussionmentioning

confidence: 91%

Does Component Alignment Affect Patient Reported Outcomes following Bicruciate Retaining Total Knee Arthroplasty? An In Vivo Three-Dimensional Analysis

Peng

Arauz

et al. 2019

J Knee Surg

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AbstractThis is an experimental study. Anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) retaining bicruciate retaining (BCR) total knee arthroplasty (TKA) have the potential to restore normal knee kinematics and thus improve patient outcome. Limited studies have examined the relationship between component alignment and patient-reported outcome measures (PROM). This study aims to determine (1) accurate three-dimensional (3D) component alignment of BCR TKA and (2) whether the component alignment of BCR TKA affects PROMs. The 3D modeling analysis was performed based on computed tomography images from 29 BCR TKAs. Component orientations were quantified for femoral and tibial components in the sagittal, axial, and coronal planes. The knee society scores (KSS) were collected preoperatively and postoperatively at 1-year follow-up. Multiple comparisons were performed to analyze the relationship between component alignment and patient outcomes. High variability was observed in the tibial component alignment (root–mean-square values: axial plane 6.6 degrees, sagittal plane 5.1 degrees, and coronal plane 4.0 degrees). At 1-year follow-up, significant improvement in KSS was noted in BCR TKA patients (p < 0.001). However, regression analysis adjusting for baseline KSS demonstrated the postoperative KSS was negatively associated with the posterior tibial slope (B [slope of the output of the regression analysis] = 2.597, p = 0.006). Patients with greater posterior tibial slopes were reported poorer postoperative functions at 1-year follow-up. Excessive posterior tibial slope may generate greater posterior force on the femur that leads to continuous overloading of the preserved ACL, suggesting optimal sagittal plane alignment of the tibial component may be important for the optimization of postoperative functions of BCR TKA patients.

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Section: Discussionmentioning

confidence: 91%

Does Component Alignment Affect Patient Reported Outcomes following Bicruciate Retaining Total Knee Arthroplasty? An In Vivo Three-Dimensional Analysis

Peng

Arauz

et al. 2019

J Knee Surg

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“…More than 20% of patients undergoing total knee arthroplasty (TKA) report chronic pain or dissatisfaction [8,19,29,39]. Bicruciate-retaining (BCR) prostheses have been identiied as promising to improve patient satisfaction by optimal restoration of normal knee kinematics through less anatomy disruption [5][6][7]20]. However, BCR use is debated by orthopedic surgeons as they require a more complex surgical technique and may cause post-operative stifness [24,26,37].…”

Section: Introductionmentioning

confidence: 99%

Bicruciate-retaining total knee arthroplasty non-inferior to posterior-stabilized prostheses after 5 years: a randomized, controlled trial

Lavoie

Denis

Chergui

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Bicruciate-retaining (BCR) prostheses may improve satisfaction of patient undergoing total knee arthroplasty (TKA). The objective of this randomized controlled trial was to assess whether BCR prostheses provide better clinical outcomes than posterior-stabilized (PS) prostheses. Materials and methods This is a randomized single-blind control trial involving a total of 77 patients with knee osteoarthritis, randomly assigned to undergo TKA with a BCR or PS implant between 2015 and 2019. Mean follow-up period was 39 months. Clinical and demographic data were extracted manually from medical records. Data acquisition included patient demographics, knee range of motion, and patient-reported outcomes via KSS, KOOS, WOMAC, and SF-12 scores. Results A total of 38 patients were randomized to the PS group and 39 to the BCR group. At the 5-year follow-up, no statistical diferences were noted for knee range of motion or patient-reported outcomes between the two groups, except for a greater knee lexion in the early follow-up period in the PS group. Five adverse events occurred in the BCR group compared to none in the PS group (p = 0.02). Conclusion BCR TKA yield similar clinical and patient-reported outcomes 5 years following the intervention compared with PS TKA. The BCR TKA had more complications. Level of evidence I (Randomized Controlled Trial).

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Walker

2020

The Artificial Knee

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Bicruciate-retaining total knee arthroplasty, a promising technology, that’s not quite there

Cited by 10 publications

References 7 publications

Does Component Alignment Affect Patient Reported Outcomes following Bicruciate Retaining Total Knee Arthroplasty? An In Vivo Three-Dimensional Analysis

Does Component Alignment Affect Patient Reported Outcomes following Bicruciate Retaining Total Knee Arthroplasty? An In Vivo Three-Dimensional Analysis

Bicruciate-retaining total knee arthroplasty non-inferior to posterior-stabilized prostheses after 5 years: a randomized, controlled trial

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