Bicruciate Total Knee Arthroplasty

Parcells, Bertrand W.; Preston, Jared S.; Tria, Alfred J.

doi:10.1007/978-3-319-34109-5_64

Cited by 7 publications

(13 citation statements)

References 66 publications

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“…Kinematic studies suggest that normal motion requires that both cruciate ligaments are viable [28, 37]. Unicompartmental knee arthroplasty retains all of the knee ligaments and the post‐operative motion closely matches normal motion, but PS and CR implants cause the motion to deviate from normal [28, 37]. However, there has been debate regarding the proprioceptive role of the PCL in arthritic knees, which affords advantages [15] and disadvantages [27, 47].…”

Section: Discussionmentioning

confidence: 99%

“…The observed differences in walking strategies are thought to have been partially attributable to both the surgical method used and the design of the artificial joints. First, removal of the PCL during surgery reduces proprioception, rendering it difficult to feel movement; this creates awkwardness during early flexion of the knee [28, 37]. Kinematic studies suggest that normal motion requires that both cruciate ligaments are viable [28, 37].…”

Section: Discussionmentioning

confidence: 99%

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Slow gait speed after bilateral total knee arthroplasty is associated with suboptimal improvement of knee biomechanics

Han

Lee

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Slow gait speed after bilateral total knee arthroplasty is associated with suboptimal improvement of knee biomechanics

Han

Lee

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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“…Cruciate ligaments are indeed crucial for the stabilization and ROM of the knee in three planes. The current literature is still controversial regarding this topic [ 62 ], most reviews suggest that no significant differences in outcome exist between PCL retaining and PCL sacrificing techniques [ 63 , 64 , 65 , 66 , 67 ]. However, it is important to note that these studies were not conducted in highly active patients.…”

Section: Discussionmentioning

confidence: 99%

Recommendations for Patients with High Return to Sports Expectations after TKA Remain Controversial

Vu-Han

Gwinner

Perka

et al. 2020

JCM

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(1) Background: Improved surgical techniques and implants in total knee arthroplasty (TKA) have led to broader indications for surgical interventions of osteoarthritis of the knee. There is a growing young and active patient subgroup with high return to sports (RTS) expectations after TKA. The current lack of evidence regarding RTS capacity in this patient cohort, requires the consolidation of experts’ opinions and experiences to address the special needs among these patients. The aim of this study was to assess current expert opinions in regard to preoperative patient assessment, surgical technique and decision-making and patient counseling for these patients. (2) Methods: We performed a survey among surgeons specialized in arthroplasty with a questionnaire designed to assess current recommendations, surgical techniques, and implant preferences as well as patient counseling in patients with high expectations for RTS after TKA. (3) Results: The majority of surgeons are in favor of return to low-impact sports after TKA within 3 to 6 months. Some even recommend return to high-impact sports. Despite improvement of surgical techniques and implants, we observed no clear preference for a single surgical technique or implant specification in active patients. (4) Conclusions: Current evidence for sports-associated complications after TKA is scarce. Despite a growing array of surgical techniques and implants, the available literature is still controversial with no single surgical technique or TKA design distinguishing itself clearly from others. Surgeons’ recommendations are mostly based on their experience and training. Nonetheless, we observed growing faith in modern implants with some surgeons even recommending high-impact sports after TKA.

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“…Bi-cruciate-retaining TKAs have also been developed. 10 Currently, there is a lack of consensus about the superiority of cruciate-retaining versus cruciate-sacrificing surgery on patient-reported outcomes, 11 - 13 despite clear kinematic benefits in retaining these ligaments. 14 …”

Section: Introductionmentioning

confidence: 99%

Early outcomes after robotic arm-assisted bi-unicompartmental knee arthroplasty compared with total knee arthroplasty: a prospective, randomized controlled trial

Blyth

Banger

Doonan

et al. 2021

The Bone & Joint Journal

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Aims The aim of this study was to compare the clinical outcomes of robotic arm-assisted bi-unicompartmental knee arthroplasty (bi-UKA) with conventional mechanically aligned total knee arthroplasty (TKA) during the first six weeks and at one year postoperatively. Methods A per protocol analysis of 76 patients, 43 of whom underwent TKA and 34 of whom underwent bi-UKA, was performed from a prospective, single-centre, randomized controlled trial. Diaries kept by the patients recorded pain, function, and the use of analgesics daily throughout the first week and weekly between the second and sixth weeks. Patient-reported outcome measures (PROMs) were compared preoperatively, and at three months and one year postoperatively. Data were also compared longitudinally and a subgroup analysis was conducted, stratified by preoperative PROM status. Results Both operations were shown to offer comparable outcomes, with no significant differences between the groups across all timepoints and outcome measures. Both groups also had similarly low rates of complications. Subgroup analysis for preoperative psychological state, activity levels, and BMI showed no difference in outcomes between the two groups. Conclusion Robotic arm-assisted, cruciate-sparing bi-UKA offered similar early clinical outcomes and rates of complications to a mechanically aligned TKA, both in the immediate postoperative period and up to one year following surgery. Further work is required to identify which patients with osteoarthritis of the knee will derive benefit from a cruciate-sparing bi-UKA. Cite this article: Bone Joint J 2021;103-B(10):1561–1570.

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Bicruciate Total Knee Arthroplasty

Cited by 7 publications

References 66 publications

Slow gait speed after bilateral total knee arthroplasty is associated with suboptimal improvement of knee biomechanics

Slow gait speed after bilateral total knee arthroplasty is associated with suboptimal improvement of knee biomechanics

Recommendations for Patients with High Return to Sports Expectations after TKA Remain Controversial

Early outcomes after robotic arm-assisted bi-unicompartmental knee arthroplasty compared with total knee arthroplasty: a prospective, randomized controlled trial

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