Modern Day Bicruciate-Retaining Total Knee Arthroplasty: A Short-Term Review of 146 Knees.

Abstract

Bicruciate retaining (BCR) implants were first proposed in the 1960s with the polycentric knee. Given the technical difficulty of implanting these devices, and the mixed results at the time, the BCR concept had stalled, until recently. This study seeks to provide a short-term review of the BCR implant design, describe patient-reported outcomes, and discuss key aspects to ensure successful implantation of the modern-day BCR implant design. Between October 2014 and December 2016, the senior author performed 146 primary total knee arthroplasties using BCR implants. Arthritic knees, with minimal soft tissue damage and an intact anterior cruciate ligament, were the general indications used for this cohort. All patients implanted with the BCR device were included in this analysis. One hundred forty-six (100%) BCR knees were available for follow-up at an average of 12 months (range, 1-33 months) postoperatively. Ninety-one percent of respondents reported their knee always or sometime feels normal, with only 9% of respondents reporting their knee never feels normal. Our study reports 94% of patients reported neutral satisfaction or higher, with only 6% of patients reporting dissatisfaction and 1% reported being very dissatisfied. Of all 146 BCR devices implanted, there were 2 (1.4%) revisions and 1 (0.7%) reoperation, a manipulation under anesthesia. This is the largest consecutive series of BCR total knee arthroplasties using the modern-day implant design with 1-year follow-up in the United States. The results of our study show great patient-reported satisfaction, function, and short-term outcomes for patients implanted with the new BCR design.