Does contemporary bicruciate retaining total knee arthroplasty restore the native knee kinematics? A descriptive literature review.
Arch Orthop Trauma Surg
; 142(9): 2313-2322, 2022 Sep.
Article
em En
| MEDLINE
| ID: mdl-34406507
ABSTRACT
BACKGROUND:
There has been no consensus on the benefit of retaining the anterior cruciate ligament (ACL) in TKAs. This study aims to review recent evidences around the kinematics of bicruciate retaining (BCR) total knee arthroplasty (TKA). MATERIALS ANDMETHODS:
A search of the literature was conducted on PubMed and Web of Science. Reports that assessed the BCR TKA kinematics, including both in vitro cadaveric studies and in vivo clinical studies, were reviewed.RESULTS:
A total number of 169 entries were obtained. By exclusion criteria, five in vitro studies using cadaveric knee specimens and six in vivo studies using patient cohorts were retained. In vitro studies showed a low internal rotation (< 10°) throughout the flexion path in all BCR TKAs. Compared to native knees, the difference in the internal rotation was maximal during early and late flexion; the femur in the BCR TKA was significantly more anteriorly positioned (1.7-3.6 mm from 0° to 110°) and more externally rotated (3.6°-4.2° at 110° and 120°). In vivo studies revealed that the native knee kinematics, in general, were not fully restored after BCR TKA during various knee activates (squatting, level-walking, and downhill-walking). There are asymmetric kinematics during the stance phase of gait cycle and a smaller range of axial rotation (23% patients exhibiting external tibial rotation) throughout the gait cycle in BCR TKAs.CONCLUSIONS:
Critical insights in the complex BCR TKA biomechanics have been reported from recent laboratory kinematics studies. However, whether contemporary BCR TKAs can fully restore native knee kinematics remains debatable, warranting further investigations.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Artroplastia do Joelho
/
Prótese do Joelho
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article