scholarly journals Bicruciate retaining total knee arthroplasty : results throughout history

2021 ◽  
Vol 87 (1) ◽  
pp. 73-83
Author(s):  
Jef De Mulder ◽  
Pieter Berger ◽  
Hilde Vandenneucker
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
Functional Results ◽  
Clinical Results ◽  
High Rate ◽  
Total Knee ◽  
High Level ◽  
Bcr Tka

Approximately 20% amongst patients are dissatisfied after total knee arthroplasty (TKA). Bicruciate retaining (BCR) TKA offers superior knee kinematics and proprioception, but many surgeons abandoned its use because of complications and technical difficulties. Recently, two new BCR implant designs were introduced : Vanguard XP (Zimmer Biomet) and Journey XR (Smith&Nephew). We searched Pubmed, Limo, Embase and Cochrane, screened reference lists of eligible studies and included studies that met the inclusion criteria. We included 35 articles reporting on ten different BCR implants, including three articles presenting results of the Vanguard XP prosthesis. Unfortunately, no articles reporting on the results of the Journey XR prosthesis had been published. The BCR implants of the early 1970s showed good functional results, but a high rate of complications, mainly loosening and infections. The Townley Anatomic TKA was the first BCR implant with good clinical results, a low incidence of loosening and a high survivorship. One article of the three reporting on the Vanguard XP yielded high patient satisfaction (94%) with two revisions (1.4%). The two other articles reported three revisions (5%) after one year of follow-up and 19 revisions (13.4%) after three years of follow-up. Throughout history, the functional results of BCR TKA improved, with lessening of the complications. The short-term results of the Vanguard XP implant showed good functional results, but two out of three articles reported a high rate of loosening. Based on the results reported in this review, the use of BCR TKA is still debatable. Further high-level evidence research is necessary to assess the clinical benefit of BCR TKA.

Postoperative Stiffening after Bicruciate-Retaining Total Knee Arthroplasty

2017 ◽  
Vol 31 (05) ◽  
pp. 453-458 ◽  
Author(s):  
Fidaa Al-Shakfa ◽  
James Moore ◽  
Lydia Mychaltchouk ◽  
Khaled Iguer ◽  
Frédéric Lavoie
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Knee Kinematics ◽  
Flexion Contracture ◽  
Early Postoperative Period ◽  
Active Population ◽  
Total Knee ◽  
Comparative Cohort Study ◽  
Bcr Tka

AbstractBicruciate-retaining (BCR) total knee arthroplasty (TKA) has recently experienced a resurgence of popularity. It may be a good option among a younger, more active population because it restores knee kinematics better than other prosthetic designs. Results obtained in the first 100 BCR TKAs implanted with a simplified gap-balancing technique are reported, with special attention paid to knee flexion, through comparison with a cohort of 100 posterior-stabilized (PS) TKAs. We conducted a retrospective comparative cohort study of 100 BCR TKAs (90 patients) and 100 PS TKAs (88 patients). Knees with a BCR TKA lost significantly more flexion PS TKA in the early postoperative period when their preoperative flexion was less than 130 degrees (loss of 40 degrees vs. loss of 24 degrees). Postoperative range of motion was similar between BCR TKA and PS TKA when preoperative knee flexion was 130 degrees or more, and when there was no preoperative flexion contracture. Postoperative stiffening seems to be more frequent and of greater magnitude after BCR TKA, compared with PS TKA, in patients suffering from preoperative flexion stiffness. Further investigation on the causes of this phenomenon is warranted.

scholarly journals Age, Sex, Body Mass Index, Education, and Social Support Influence Functional Results After Total Knee Arthroplasty

2017 ◽  
Vol 8 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Tomas Sveikata ◽  
Narunas Porvaneckas ◽  
Paulius Kanopa ◽  
Alma Molyte ◽  
Dalius Klimas ◽  
...  
Keyword(s):  
Social Support ◽  
Body Mass Index ◽  
Total Knee Arthroplasty ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Functional Results ◽  
Related Factors ◽  
Patient Groups ◽  
Total Knee

Introduction: Total knee arthroplasty (TKA) is an effective treatment for knee osteoarthritis. Patient-reported outcome after TKA is influenced by multiple patient-related factors. The aim of this study was to prospectively evaluate preoperative patient-related factors and to compare the self-reported outcomes 1 year after TKA among groups differing by age, sex, body mass index (BMI), education, and social support level. Methods: 314 patients, who underwent TKA in Vilnius Republican University Hospital between the end of 2012 and the middle of 2014, were included in a study. The preoperative and 12-month follow-up measurements were obtained using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form-12 (SF-12). Differences between patient groups according to gender, age, BMI, level of education, and level of social support were analyzed. Results: At 12-month follow-up men demonstrated better results than women in WOMAC ( P = .003) and SF-12 both domains ( P < .05). Patients with a higher social support demonstrated higher scores in physical function according to SF-12 ( P = .008). Better preoperative WOMAC and SF-12 scores were a predictor of better outcome 1 year after surgery. There was no difference in postoperative scores in different age, BMI, and education groups according to WOMAC and SF-12. Conclusion: There is no difference in self-reported functional outcome between patient groups differing in age, BMI, and education. Men and socially supported patients demonstrate better postoperative functional results 12 months after TKA. Better preoperative knee function and overall physical and mental function are predictors of better outcome 1 year after TKA. Age and obesity should not be limiting factors when considering who should receive this surgery.

scholarly journals Direct Repair of Extensor Mechanism Disruption After Total Knee Arthroplasty “A Case Series of 31 Patients”

2021 ◽  
Author(s):  
Tie-jian Li ◽  
Jing-yang Sun ◽  
Yin-qiao Du ◽  
Jun-min Shen ◽  
Bo-han Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Case Series ◽  
Quadriceps Tendon ◽  
Clinical Results ◽  
Extensor Mechanism ◽  
Direct Repair ◽  
Kaplan Meier ◽  
Total Knee

Abstract Background Extensor mechanism disruption following total knee arthroplasty is a destructive complication with poor outcomes. Presently, limited data exists regarding the direct repair therapy and long-term outcomes. This study was to evaluate the clinical results and complications of direct repair therapy, and compare it with similar studies to determine whether there is a better treatment. Methods During the period of 2008 to 2020, 31 patients underwent direct repair for an extensor mechanism disruption after total knee arthroplasty (15 patellar fractures, 9 patellar tendon disruptions, and 7 quadriceps tendon disruptions). Mean follow-up was 4.9 years. Demographic, operative, and clinical data were collected. The following statistical methods will be employed to analyze the data: descriptive statistics, paired t test, and the Kaplan-Meier method. Results For all 31 patients underwent direct repair for extensor mechanism disruption, 6 patients failed : 2 knees (6%) of infections and 4 knees (13%) of re-rupture. ROM was 94.1° ± 15.7° preoperatively to 73° ±52° postoperatively, average extensor lag reduced from 45° to 20.2° at follow-up, and the WOMAC and HSS averaged 65 and 72 points. The Kaplan-Meier estimated survivorship with failure for complications as the end point was 81% (95% confidence interval [95% CI], 42.7% to73.3%) at 12 years. Conclusion Direct repair of the extensor mechanism disruption is not an ideal therapy, it’s actually ineffective for the recovery of knee joint function in patients, and will remain severe knee extension lag. No matter which part of the extensor mechanism disruption, direct repair should not be the preferred treatment

scholarly journals Patellar reconstruction following previous patellectomy: a review of the literature and a case series using distal femoral autograft during total knee arthroplasty

2017 ◽  
Vol 99 (3) ◽  
pp. e97-e101
Author(s):  
DA George ◽  
A Dosani ◽  
R Morgan-Jones
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femoral Condyle ◽  
Case Series ◽  
Knee Kinematics ◽  
Alternative Methods ◽  
Small Series ◽  
Total Knee ◽  
Resected Femoral

During total knee arthroplasty, the reconstruction of the patella following a previous patellectomy is challenging, and is undertaken to improve functional outcomes and patient satisfaction. In this case series, we have reconstructed the patella using a femoral condyle resected during total knee arthroplasty. The resected femoral condyle with best available bone stock is selected and secured to the extensor mechanism. We reviewed the preoperative indications and postoperative outcomes of two patients who underwent the above procedure at our Institute, and compared this to the literature. The cases include a 68-year old male (6 months follow-up) who sustained a multi-fragmentary fracture of his right patella and underwent a patellectomy 30 years previously, and a 45-year old female (4 years follow-up) who underwent a left-sided patellectomy 15 years previously following polytrauma. As a result of progressive osteoarthritis they required total knee arthroplasty, and simultaneous patella reconstruction with a femoral condyle autograft. Compared to their preoperative range of motion, both patients demonstrated an improvement post-operatively with successful pain-free knee function, with no radiological signs of graft resorption. In this limited, small series we have reported two patients who are clinically and functionally satisfied by the outcome of surgery, with comparable outcomes to alternative methods. We believe the use of a femoral condyle autograft for patellar reconstruction is a safe and simple technique that optimises knee kinematics, without associated donor morbidity.

scholarly journals Results of total knee arthroplasty for painless, stiff knees

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Young-Joon Choi ◽  
Dong-Kyo Seo ◽  
Ki Won Lee ◽  
Ho Jong Ra ◽  
Hyun Wook Kang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Case Series ◽  
High Rate ◽  
Total Knee ◽  
The Mean

Abstract Background Stiff knees, like completely ankylosed or arthrodesed knees, can be painless. Total knee arthroplasty (TKA) for these painless, stiff knees is technically demanding. However, it can correct the alignment and advance the range of motion to improve quality of life. So, we reviewed the preoperative and postoperative results of functional and pain scores, range of motion (ROM) and complications in painless, stiff knees treated by TKA. Methods Fifteen painless, stiff knees underwent TKA from January 1998 to January 2017. The mean follow-up period was 15.4 (2.4–22.2) years. All the knees were completely ankylosed or arthrodesed. Clinical outcome and complications were evaluated using medical record review, serial plan radiography, ROM assessment, Knee Society score (KSS), Knee Society function score (FS), and a visual analog scale for pain (VAS). Results All patients were satisfied with their operated knees. Mean KSS and FS scores were improved from 36 and 50.9 to 76.9 and 67.2, respectively (P < 0.001 and P = 0.01). The mean ROM increased from 0º preoperatively to 77.6º (15–130) at the final follow-up (P < 0.001). The mean VAS had worsened from 0 preoperatively to 0.2 postoperatively, however it was not significant (P = 0.1). Major postoperative complications were reported in five of the knees (33.3%). Conclusions The results of TKA for painless, stiff knees were satisfactory with improved ROM and quality of life. Although some patients had mild pain and complications postoperatively, they were satisfied with the result. However, our study recommends that surgeons should consider the high rate of complications in the completely ankylosed or arthrodesed knees. Level of evidence A retrospective case series, Level IV.

Gender Influences Gait Asymmetry following Bicruciate-Retaining Total Knee Arthroplasty

2019 ◽  
Vol 33 (06) ◽  
pp. 582-588 ◽  
Author(s):  
David Hennessy ◽  
Paul Arauz ◽  
Christian Klemt ◽  
Shuai An ◽  
Young-Min Kwon
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Imaging System ◽  
Knee Kinematics ◽  
Male And Female ◽  
Female Patients ◽  
Total Knee ◽  
Bcr Tka ◽  
Anterior Posterior

AbstractThis is an experimental study. Gender has been reported to influence outcomes in patients with total knee arthroplasty (TKA) for knee osteoarthritis (OA). However, the influence of gender on three-dimensional (3D) in vivo kinematics during gait remains unclear. This study aimed to determine if 3D gait kinematics, including 3D knee translations and rotations, differed in men and women following bicruciate-retaining (BCR) TKA. Twenty-nine well-functioning unilateral BCR TKA patients (14 males and 15 females) underwent evaluation of both knees during level walking on a treadmill at a self-selected speed using a dual fluoroscopic imaging system. Interlimb comparisons of in vivo 6 degree-of-freedom kinematics were compared between male and female patients. Differences of pre- and postoperative Knee Society scores (KSSs) were compared between the groups. Both groups were matched regarding age and body mass index. Both male and female patients demonstrated improvement in their postoperative KSSs. Statistically significant differences were observed with respect to spatiotemporal anterior–posterior interlimb translations (p < 0.05). Although females presented more femoral posterior translation in the operative knee than the nonoperative knee during most of the stance phases (2.8 vs. −1.6 mm), males exhibited less femoral translation in the operative knee than the nonoperative knee (2.3 vs. −1.8 mm), when interlimb differences were detected during stance phase. Results demonstrated that there are 3D motion asymmetries of the knee in both male and female unilateral BCR TKA patients during gait with anterior–posterior interlimb asymmetries significantly greater in female than male participants. This suggests that gender may influence the in vivo knee kinematics in BCR TKA patients during gait.

scholarly journals In vivo kinematics and cruciate ligament forces in bicruciate-retaining total knee arthroplasty

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kenichi Kono ◽  
Hiroshi Inui ◽  
Tetsuya Tomita ◽  
Takaharu Yamazaki ◽  
Shoji Konda ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Knee Kinematics ◽  
Anteroposterior Translation ◽  
Total Knee ◽  
Bcr Tka ◽  
Femoral Condyles

AbstractWe analyzed the effects of bicruciate-retaining total knee arthroplasty (BCR-TKA) on knee kinematics and cruciate ligament forces. Patients (N = 15) with osteoarthritis (OA) and an intact anterior cruciate ligament (ACL) underwent magnetic resonance imaging and single-plane fluoroscopy to measure tibiofemoral kinematics during two deep knee bend activities before and after BCR-TKA: (1) weight-bearing squat; (2) non-weight-bearing cross-legged sitting. Forces in ligament bundles were calculated using VivoSim. The dynamic range of varus-valgus angulation decreased from 3.9 ± 4.4° preoperatively to 2.2 ± 2.7° postoperatively. Preoperatively, the medial femoral condyle translated anteriorly from 10° to 50° of flexion, and posteriorly beyond 50° of flexion. Postoperatively, the medial and lateral femoral condyles translated posteriorly throughout flexion in a medial pivot pattern. ACL forces were high in extension and decreased with flexion pre- and postoperatively. PCL forces increased with flexion preoperatively and did not change significantly postoperatively. Preoperatively, ACL forces correlated with anteroposterior translation of the femoral condyles. Postoperatively, PCL forces correlated with anteroposterior translation of the lateral femoral condyle. BCR-TKA altered knee kinematics during high flexion activity which correlated significantly with changes in cruciate ligament forces.

Clinical results of alumina medial pivot total knee arthroplasty at a minimum follow-up of 10 years

The Knee ◽  
2017 ◽  
Vol 24 (2) ◽  
pp. 434-438 ◽  
Author(s):  
Suguru Nakamura ◽  
Yukihide Minoda ◽  
Shigeru Nakagawa ◽  
Yoshinori Kadoya ◽  
Susumu Takemura ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Clinical Results ◽  
Medial Pivot ◽  
Total Knee
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