Abstract
Patient expectations have escalated over the past several decades with respect to demand for success with total knee arthroplasty (TKA). It is reported that 15 to 20% of TKA recipients are unsatisfied with their result. Dynamic fluoroscopic studies and gait analyses have demonstrated that patients with TKA do not exhibit normal kinematics. On the other hand, patients with partial knee arthroplasty demonstrate more normal kinematics, thought to be secondary to retention of the anterior cruciate ligament (ACL) along with the posterior cruciate ligament (PCL). While not a new concept, bi-cruciate retaining designs in TKA that preserve the natural ligament structure of the knee are drawing renewed interest as an option for patients with higher and more complex activity demand. These designs may result in a more natural kinematic feel as perceived by the patient. This surgical demonstration will outline patient selection criteria and illustrate the technique for performing ACL- and PCL-preserving, bi-cruciate retaining TKA.
