Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 12;24(1):965.
doi: 10.1186/s12891-023-07083-5.

Short-term clinical results of bicruciate-retaining total knee arthroplasty using personalized alignment

Hiroshi Inui  1   2 , Ryota Yamagami  3 , Kenichi Kono  3 , Kohei Kawaguchi  3 , Tomofumi Kage  3 , Ryo Murakami  3 , Haruhiko Nakamura  4 , Kazuo Saita  4 , Shuji Taketomi  3 , Sakae Tanaka  3
Affiliations

Short-term clinical results of bicruciate-retaining total knee arthroplasty using personalized alignment

Hiroshi Inui et al. BMC Musculoskelet Disord. .

Abstract

Background: Bicruciate-retaining (BCR) prosthesis has been introduced to recreate normal knee movement by preserving both the anterior and posterior cruciate ligaments. However, the use of BCR total knee arthroplasty (TKA) is still debatable because of several disappointing reports. We have been performing BCR TKAs with personalized alignment (PA). This study aimed to reveal the limb alignment and soft tissue balance of FA-BCR TKAs and compare the clinical outcomes of FA-BCR TKAs with those of unicompartmental knee arthroplasty (UKA).

Methods: Fifty BCR TKAs and 58 UKAs were included in this study. The joint component gaps of BCR TKA were evaluated intraoperatively and the postoperative hip-knee-ankle (HKA) angle, medial proximal tibial angle (MPTA), and lateral distal femoral angle (LDFA) were measured using full-length standing radiography. The short-term clinical outcomes of BCR TKAs were compared with those of UKA using the scoring system of 2011 Knee Society Scoring (KSS) and the knee injury and osteoarthritis outcome score (KOOS) at an average of 2 years postoperatively (1-4yeras).

Results: The coronal alignment values of PA-BCR TKA were as follows: HKA angle, 177.9° ± 2.3°; MPTA, 85.4° ± 1.9°; and LDFA, 87.5° ± 1.9°. The joint component gaps at flexion angles of 10°, 30°, 60°, and 90° were 11.1 ± 1.2, 10.9 ± 1.4, 10.7 ± 1.3, and 11.2 ± 1.4 mm for the medial compartment and 12.9 ± 1.5, 12.6 ± 1.8, 12.5 ± 1.8 and 12.5 ± 1.7 mm for the lateral compartment, respectively. The patient expectation score and maximum extension angle of PA-BCR TKA were significantly better than those of UKAs.

Conclusions: The short-term clinical outcomes of PA-BCR TKA were comparable or a slightly superior to those of UKAs.

Keywords: Bi-cruciate retaining total knee arthroplasty; Patient-reported outcomes; Personalized alignment; Short-term clinical outcomes; Unicompartmental knee arthroplasty.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Vaus-valgus stress was applied to evaluate the medial and lateral joint laxity using the navigation system
Fig. 2
Fig. 2
The amount of the tibial bone resection for the varus knee
Fig. 3
Fig. 3
The picture of the tensor device. Measurement of the joint component gap of medial and lateral compartments, respectively, using the tensor device. The upper plates had identical shapes of medial and lateral compartments of the polyethylene surface of the Journey II system
Fig. 4
Fig. 4
Joint component gap of PA BCR TKA. The joint component gaps of the lateral compartment were significantly larger than those of the medial compartment at each flexion angle. No significant differences were found between the medial and lateral component gaps at each flexion angle. *P < 0.001. FA: functional alignment BCR: bi-cruciate retaining, TKA: total knee arthroplasty
See this image and copyright information in PMC

References

    1. Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res 2010;468(1):57–63. 10.1007/s11999-009-1119-9. - PMC - PubMed
    1. Becker R, Döring C, Denecke A, Brosz M. Expectation, satisfaction and clinical outcome of patients after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2011;19(9):1433–41. 10.1007/s00167-011-1621-y. - PubMed
    1. Pritchett JW. Patients prefer a bicruciate-retaining or the medial pivot total knee prosthesis. J Arthroplasty. 2011;126(2):224–228. doi: 10.1016/j.arth.2010.02.012. - DOI - PubMed
    1. Pritchett JW. J Bone Joint Surg Br. 2004;86(7):979–82. doi: 10.1302/0301-620x.86b7.14991. - DOI - PubMed
    1. Christensen JC, Brothers J, Stoddard GJ, Anderson MB, Pelt CE, Gililland JM, Peters CL. Higher frequency of reoperation with a new bicruciate-retaining total knee arthroplasty. Clin Orthop Relat Res. 2017;475(1):62–69. doi: 10.1007/s11999-016-4812-5. - DOI - PMC - PubMed

MeSH terms