Reduced joint-awareness in bicruciate-retaining total knee arthroplasty compared to cruciate-sacrificing total knee arthroplasty

Arch Orthop Trauma Surg. 2018 Feb;138(2):273-279. doi: 10.1007/s00402-017-2839-z. Epub 2017 Nov 9.


Purpose: There is rising impact of patient-reported outcome (PRO) measurement in joint arthroplasty over the past years. Bicruciate-retaining implants have shown more physiologic knee kinematics and provide superior proprioceptive capacities. The aim of this study was to evaluate if the functional properties of this new implant design lead to improved PRO results after total knee arthroplasty (TKA).

Methods: This prospective, controlled trial compares PRO of bicruciate-retaining total knee arthroplasty (BCR-TKA) to unicondylar knee arthroplasty (UKA) and standard posterior-stabilized total knee arthroplasty (PS-TKA). We evaluated 102 patients (34 patients in each group) 18 months postoperatively after knee arthroplasty. Primary outcome measure was the Forgotten Joint Score (FJS).

Results: The BCR-group showed the same level of joint awareness as the UKA-group (p = 0.999). The second control group of PS-TKA patients had a lower mean score value in the FJS compared to the BCR-group (p = 0.035) and UKA-group (p = 0.031). There was no correlation of age, gender, body mass index (BMI) and the FJS. No relevant floor- or ceiling effects occurred.

Conclusions: This study found reduced joint awareness for BCR-TKA compared to a standard total knee arthroplasty. The score values of the BCR-group were equal to the UKA-group. Further prospective, randomized studies to investigate long-term survivorship of bicruciate-retaining implants are needed.

Level of evidence: Level II.

Keywords: Bicruciate-retaining total knee arthroplasty (BCR-TKA); Forgotten Joint Score (FJS); Outcome; Patient Reported Outcome Measurement (PROM); Unicompartmental knee arthroplasty (UKA).

MeSH terms

  • Arthroplasty, Replacement, Knee* / adverse effects
  • Arthroplasty, Replacement, Knee* / methods
  • Arthroplasty, Replacement, Knee* / statistics & numerical data
  • Biomechanical Phenomena
  • Humans
  • Knee Joint / physiology
  • Knee Joint / surgery*
  • Knee Prosthesis* / adverse effects
  • Knee Prosthesis* / statistics & numerical data
  • Ligaments, Articular / surgery*
  • Organ Sparing Treatments
  • Prospective Studies
  • Treatment Outcome