Early results with a bicruciate-retaining total knee arthroplasty: a match-paired study
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ORIGINAL ARTICLE
Early results with a bicruciate‑retaining total knee arthroplasty: a match‑paired study Alessio Biazzo1 · Riccardo D’Ambrosi2 · Eric Staals3 · Francesco Masia1 · Vincenzo Izzo1 · Francesco Verde1 Received: 23 July 2020 / Accepted: 10 November 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Background The aim of this study is to compare 2 groups of total knee arthroplasties (TKAs): the bicruciate-retaining (BCR—group) and cruciate-retaining total knee arthroplasty (CR—group), evaluating the functional results in the shortterm follow-up. Methods 24 BCR were included in the study and were compared with a group of 24 TKAs performed with the same implant, but with sacrifice of the ACL and retention of the posterior cruciate ligament. For preoperative and postoperative clinical evaluation, the visual analogue score (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used. Radiological evaluation included weight-bearing long-leg view, a Rosemberg view, lateral view of the knee and tangential view of the patella. Hip-knee-ankle angle (HKA) was recorded pre and postoperatively. Radiolucent lines (RLLs) were evaluated according the Knee Society Roentgenographic Evaluation System (KSRES). Results At last follow-up the mean VAS score was 1.81 for BCR group and 1.43 for CR group (p = 0.61). The mean WOMAC score was 8.68 for BCR group and 12.81 for CR group (p = 0.33). As for the radiological evaluation, preoperative HKA angle was 0.53° varus for BCR group and 3.14° varus for CR group (p = 0.24); postoperative HKA was 0.72° valgus for BCR group and 0.38° valgus for CR group (p = 0.75). The percentage of RLLs was similar between the two groups (12% versus 15%). Conclusions BCR-TKA has showed to give similar functional and radiographic outcomes compared to conventional CR-TKA in a similar cohort of patients. An higher operative times and higher number of complications respect were found in BCR group. These results can be explained by the early learning curve experiences. Future randomized controlled trials should be performed to support new implant designs such as BCR. Level of evidence Level of evidence Case–control study, level III. Keywords Total knee arthroplasty · Bicruciate-retaining · Cruciate retaining · Osteoarthritis · Biomechanics
Introduction Reproducing the anatomy and kinematics of the knee as much as possible is an important goal in total knee arthroplasty (TKA), as it has shown to reduce the percentage of dissatisfied patients and improve long-term results [1]. Several studies demonstrated that preserving the anterior and posterior cruciate ligaments in TKA restores the anatomy * Riccardo D’Ambrosi [email protected] 1
Hip and Knee Reconstructive Surgery Department, Humanitas Gavazzeni, Bergamo, Italy
2
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
3
Istituto Ortopedico Rizzoli, Bologna, Italy
and kinematics of the normal knee [2–6]. Indeed, it has been shown that especially the anterior cruciate l
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