Boese, Christoph Kolja, Ebohon, Stephen, Ries, Christian and De Faoite, Diarmuid . Bi-cruciate retaining total knee arthroplasty: a systematic literature review of clinical outcomes. Arch. Orthop. Trauma Surg.. NEW YORK: SPRINGER. ISSN 1434-3916

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Abstract

Total knee arthroplasty (TKA) has been shown to have good long-term outcomes and survivorship. Nonetheless, dissatisfied patients are frequently reported in the literature. Bi-cruciate retaining total knee prostheses (BCR TKA) were designed to address the demand for more kinematically functional implants that better reconstruct natural knee kinematics. In BCR TKA, the anterior cruciate ligament (ACL) is preserved. Improved patient-reported outcomes and satisfaction levels are expected. This review aimed to summarize indications for and clinical outcomes of BCR TKA. A systematic literature review on BCR TKA was performed. 24 articles were included for data analysis. Indications covered osteoarthritis, inflammatory arthritis and others. The degree of deformity was often but not always limited to minor axial deformity and contractures: maximum acceptable varus/valgus deformity reached 10 degrees-30 degrees and flexion contractures of 15 degrees-65 degrees. ACL intactness was macroscopically examined intraoperatively in nine studies and clinically tested in ten studies (e.g., Lachmann Test, drawer-test). Objective and patient-reported outcome scores were reported for follow-up periods of up to 22 years. Survival rates varied significantly. For first generation implants, 22-year survival reached 82% while a second generation design was associated with 13.5% revision rate at 18 months. Reasons for varying outcomes were not clear and may be attributed to the implant itself, surgical techniques and patient specific variables including changed expectations and functional demand. The literature has not shown clear indications and guidelines for the use of BCR implants. The promising results of first generation BCR TKA designs may be optimized through improved implant designs in the future. Further studies are advocated to provide the necessary evidence of second generation BCR TKA designs.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Boese, Christoph KoljaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ebohon, StephenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ries, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Faoite, DiarmuidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-315173
DOI: 10.1007/s00402-020-03622-0
Journal or Publication Title: Arch. Orthop. Trauma Surg.
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1434-3916
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
IN-VIVO KINEMATICS; SURVIVORSHIP ANALYSIS; REPLACEMENT; LIGAMENTS; RETENTIONMultiple languages
Orthopedics; SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/31517

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