Kinematics of bicruciate stabilized and cruciate retaining total knee arthroplasty

Few studies have been reported about kinematic comparison between bicruciate stabilized and cruciate retaining total knee arthroplasty with the same anatomical surface geometry. The aim of this study was to demonstrate the in vivo kinematics and postoperative patient-reported outcomes of these two surgeries with the same anatomical surface geometry. We analyzed 17 bicruciate stabilized and 18 cruciate retaining total knee arthroplasties using single-plane fluoroscopic surveillance with two- to three-dimensional registration techniques during squatting from minimum to maximum flexion. Flexion angle, femoral external rotation, anteroposterior position of the medial and lateral sides, and postoperative 2011 Knee Society Scores were analyzed. Maximum flexion angles were larger for bicruciate stabilized than for cruciate retaining total knee arthroplasties. There was no significant difference in femoral external rotation between the two types. The medial and lateral femoral condyles in bicruciate stabilized type translated more posteriorly during deeper flexion and at maximum flexion angle, respectively, than those in cruciate retaining total knee arthroplasty. Both groups revealed medial pivots in early flexion, but during deep flexion, bicruciate stabilized total knee arthroplasty revealed bicondylar roll-back and cruciate retaining total knee arthroplasty revealed paradoxical anterior motion. Both groups exhibited similar results in postoperative 2011 Knee Society Scores. Bicruciate stabilized and cruciate retaining total knee arthroplasties with the same anatomical articular surfaces demonstrated different kinematics patterns during squatting. However, there were no significant differences in postoperative 2011 Knee Society Scores between the two types of surgery.