Early results with a bicruciate-retaining total knee arthroplasty: a match-paired study

Biazzo, Alessio; D’Ambrosi, Riccardo; Staals, Eric L.; Masia, Francesco; Izzo, V.; Verde, Francesco

doi:10.1007/s00590-020-02834-9

Cited by 4 publications

(8 citation statements)

References 29 publications

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“…Alnachoukati et al [ 23 ] reported a mean postoperative increase in flexion values (116° preoperative to 121° postoperative) and a mean improvement in terms of KSS (48 to 96). Biazzo et al [ 49 ] compared functional outcomes between 24 BCR TKA knees [Vanguard XP Total Knee System (Zimmer Biomet)] and 24 CR TKA knees [Vanguard ID Total Knee System (Zimmer Biomet)] in short-term follow up; at the last follow-up, they showed a higher mean Western Ontario and McMaster Osteoarthritis index (WOMAC) score for the BCR group (8.68) than for the CR group (12.81) but no statistically significant difference between the groups ( P = 0.33). Baumann et al [ 20 ] demonstrated the superior proprioceptive function of a bicruciate-retaining implant [Vanguard XP Total Knee System (Zimmer Biomet)] compared to unicondylar knee arthroplasty (UKA) and posterior-stabilized TKA (Genesis II Total Knee Replacement System; Smith and Nephew plc, Watford, United Kingdom) at mean follow-up of 18 mo.…”

Section: Clinical Resultsmentioning

confidence: 99%

“…A match-paired study with a mean follow-up of 33.82 mo carried out by Biazzo et al [ 49 ] reported two major and two minor complications after implant of 24 BCR TKA [Vanguard XP Total Knee System (Zimmer Biomet)]. There were two aseptic loosening cases with revisions of the tibial component, on periprosthetic joint infection treated conservatively, and one intraoperative fracture of the intercondylar tibial eminence fixed by cortical screw.…”

Section: Complications and Revision Ratesmentioning

confidence: 99%

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Bicruciate-retaining total knee arthroplasty: What’s new?

Sabatini

Barberis

Camazzola

et al. 2021

WJO

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Primary total knee arthroplasty (TKA) is a widespread procedure to address end stage osteoarthritis with good results, clinical outcomes, and long-term survivorship. Although it is frequently performed in elderly, an increased demand in young and active people is expected in the next years. However, a considerable dissatisfaction rate has been reported by highly demanding patients due to the intrinsic limitations provided by the TKA. Bicruciate-retaining (BCR) TKA was developed to mimic knee biomechanics, through anterior cruciate ligament preservation. First-generation BCR TKA has not gained popularity due to its being a challenging technique and having poor survival outcomes. Thanks to implant design improvement and surgeon-friendly instrumentation, second-generation BCR TKA has seen renewed interest. This review will focus on surgical indications, kinematical basis, clinical results and latest developments of second-generation BCR TKA.

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Section: Clinical Resultsmentioning

confidence: 99%

Section: Complications and Revision Ratesmentioning

confidence: 99%

Bicruciate-retaining total knee arthroplasty: What’s new?

Sabatini

Barberis

Camazzola

et al. 2021

WJO

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“…In contrast, Longo et al [58] demonstrated that PS TKA had a statistically significant greater postoperative improvement of KSFS compared with the CR group. Some studies reported that BCR TKA showed similar other PROMs such as the visual analogue score and the Forgotten Joint Score when compared to CR TKA [9,59] . However, for the newly designed BCS TKA, it resulted in significantly better outcomes when compared with PS TKA in other PROMs such as the Knee injury and Osteoarthritis Outcome Score and stair-climbing ability [42,60] .…”

Section: Discussionmentioning

confidence: 99%

“…BCR TKA retains the PCL as well as the ACL. A recent study showed that BCR TKA had similar functional and radiographic outcomes compared to CR TKA in a similar cohort of patients [9] . BCS TKA was designed to promote normal knee kinematics by incorporating both anterior and posterior post-cam mechanisms to replicate the function of ACL and PCL.…”

Section: Introductionmentioning

confidence: 99%

Comparison of clinical outcomes among total knee arthroplasties using posterior-stabilized, cruciate-retaining, bi-cruciate substituting, bi-cruciate retaining designs: a systematic review and network meta-analysis

Sun¹,

Wu²,

Wu³

et al. 2023

Chinese Medical Journal

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Background:Despite the advent of innovative knee prosthesis design, a consistent first-option knee implant design in total knee arthroplasty (TKA) remained unsettled. This study aimed to compare the clinical effects among posterior-stabilized (PS), cruciate-retaining (CR), bi-cruciate substituting (BCS), and bi-cruciate retaining designs for primary TKA.Methods:Electronic databases were systematically searched to identify eligible randomized controlled trials (RCTs) and cohort studies from inception up to July 30, 2021. The primary outcomes were the range of knee motion (ROM), and the secondary outcomes were the patient-reported outcome measures (PROMs) and complication and revision rates. Confidence in evidence was assessed using Confidence in Network Meta-Analysis. The Bayesian network meta-analysis was performed for synthesis.Results:A total of 15 RCTs and 18 cohort studies involving 3520 knees were included. The heterogeneity and inconsistency were acceptable. There was a significant difference in ROM at the early follow-up when PS was compared with CR (mean difference [MD] = 3.17, 95% confidence interval [CI] 0.07, 7.18) and BCS was compared with CR (MD = 9.69, 95% CI 2.18, 17.51). But at the long-term follow-up, there was no significant difference in ROM in any one knee implant compared with the others. No significant increase was found in the PROMs and complication and revision rates at the final follow-up time.Conclusions:At early follow-up after TKA, PS and BCS knee implants significantly outperform the CR knee implant in ROM. But in the long run, the available evidence suggests different knee prostheses could make no difference in clinical outcomes after TKA with extended follow-up.

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“…Some studies have shown that BCR TKAs may be preferable over traditional ACL-sacri cing TKAs [3,4]. However, the use of BCR TKAs is still debatable among orthopedic surgeons because most of the reports on BCR TKAs showed clinical outcomes similar to other ACL-sacri cing TKAs and not a few studies have reported a high complication rate, including stiffness and early revision [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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

Inui,

Yamagami,

Kono

et al. 2023

Preprint

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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 functional alignment (FA). 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 This study evaluated the joint component gap of BCR TKA intraoperatively and measured the postoperative hip–knee–ankle (HKA) angle, medial proximal tibial angle (MPTA), and lateral distal femoral angle (LDFA) using full-length standing radiography. The short-term clinical outcomes of BCR TKAs were compared with those of UKA at an average of 2 years postoperatively (1-4yeras). Results The coronal alignment values of FA-BCR TKA were as follows: HKA angle, 177.9° ± 2.3°; MTPA, 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 FA-BCR TKA were significantly better than those of UKAs. Conclusions The short-term clinical outcomes of FA-BCR TKA were comparable or a slightly superior to those of UKAs.

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Early results with a bicruciate-retaining total knee arthroplasty: a match-paired study

Cited by 4 publications

References 29 publications

Bicruciate-retaining total knee arthroplasty: What’s new?

Bicruciate-retaining total knee arthroplasty: What’s new?

Comparison of clinical outcomes among total knee arthroplasties using posterior-stabilized, cruciate-retaining, bi-cruciate substituting, bi-cruciate retaining designs: a systematic review and network meta-analysis

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

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