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Does contemporary bicruciate retaining total knee arthroplasty restore the native knee kinematics? A descriptive literature review

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机构: [1]Department of Orthopaedic Surgery, Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, 159 Wells Avenue, Newton, MA 02459, USA [2]Department of Orthopaedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA [3]NuVasive Inc, San Diego, CA, USA [4]Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China
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关键词: Bicruciate retaining Total knee arthroplasty Kinematics In vitro and in vivo Biomechanics

摘要:
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 and methods 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 degrees) 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 degrees to 110 degrees) and more externally rotated (3.6 degrees-4.2 degrees at 110 degrees and 120 degrees). 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.

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出版当年[2021]版:
大类 | 3 区 医学
小类 | 2 区 骨科 2 区 外科
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 骨科 3 区 外科
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出版当年[2020]版:
Q2 ORTHOPEDICS Q2 SURGERY
最新[2023]版:
Q2 SURGERY Q2 ORTHOPEDICS

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第一作者机构: [1]Department of Orthopaedic Surgery, Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, 159 Wells Avenue, Newton, MA 02459, USA [2]Department of Orthopaedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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