Smith + Nephew, Baar, Switzerland.
Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
PLoS One. 2020 Jun 15;15(6):e0234616. doi: 10.1371/journal.pone.0234616. eCollection 2020.
There is limited evidence on total knee arthroplasty (TKA) that retains the anterior and the posterior cruciate ligaments. Bi-cruciate retaining (BCR) TKA is considered to show improved clinical function and kinematics. This survey aimed to (1) identify interest in and acceptance of BCR TKA surgery and (2) to capture the range of indications for BCR in the opinion of practicing knee surgeons. 346 surgeons with experience in TKA surgery completed a bi-lingual online survey. Demographics, arthroplasty experience as well as acceptance of and indications for BCR TKA were collected. 53 surgeons were experienced in BCR TKA and 225 would consider implanting it. A mean of 19.5% of TKA patients were considered eligible for BCR TKA. 56.3% were thought to have intact ACL at the time of TKA surgery. Surgeons were not likely to perform BCR TKA in patients with inflammatory arthritis, aged over 80, BMI above 34.9 kg/m2, a varus or valgus deformity of more than 10° and flexion contractures of more than 10°. There is strong interest among orthopedic surgeons to perform BCR TKA and the percentage of potentially eligible patients is high. Significant joint deformity is a limitation of BCR TKA, while age and high BMI are less relevant. BCR TKA experienced surgeons are less restrictive.
保留前、后交叉韧带的全膝关节置换术（TKA）的证据有限。双交叉韧带保留（BCR）TKA 被认为具有更好的临床功能和运动学效果。本研究旨在：（1）确定对 BCR TKA 手术的兴趣和接受程度；（2）了解膝关节外科医生对 BCR 的适应证范围的看法。346 名具有 TKA 手术经验的外科医生完成了一项双语在线调查。收集了人口统计学、关节置换经验以及对 BCR TKA 的接受程度和适应证。53 名外科医生有 BCR TKA 经验，225 名将考虑植入。平均 19.5%的 TKA 患者被认为适合接受 BCR TKA。56.3%的患者在 TKA 手术时被认为 ACL 完整。对于患有炎症性关节炎、年龄超过 80 岁、BMI 超过 34.9kg/m2、超过 10°的内翻或外翻畸形以及超过 10°的屈曲挛缩的患者，外科医生不太可能进行 BCR TKA。骨科医生对进行 BCR TKA 有强烈的兴趣，且潜在的合格患者比例较高。明显的关节畸形是 BCR TKA 的局限性，而年龄和高 BMI 则不太相关。有 BCR TKA 经验的外科医生限制较少。
