Is modem bicruciate retaining TKA feasible?

摘要

Early bicruciate retaining total knee arthroplasty (TKA) deisgns were abandoned due to high failure rates. Twenty bicruciate TKAs were retrieved and analyzed to determine the mechanisms of failure. Failures occurred predominately on the tibial side due to fracture of the anterior tibial tray or bridge, insert dissociation, UHMWPE wear, and tibial component loosening. Modem implant designs and materials may increase the strength of the tibial baseplate, durability of the liner locking mechanism, and UHMWPE wear resistance, while better surgical techniques may improve implant fixation suggesting that bicruciate retaining TKA could be feasible. However, long-term studies will be necessary to determine if the durability of modem bicruciate retaining TKAs is equivalent to contemporary CR and PS designs. Bicruciate retaining (BCR) total knee arthroplasies (TKA) were used in the United Sates in the 1970s and 1980s. Early designs of BCR TKA consisted essentially of two unicompartmental replacements connected by an anterior bridge [1]. BCR TKA maintains both anterior and posterior cruciate ligaments potentially restoring more normal knee kinematics and a greater rate of patient preference [2,3]. However, these early designs of BCR implants were abandoned due to unexpectedly high failure rates.