Trial reportActa orthopaedica2026
Bicruciate-retaining versus cruciate-retaining total knee arthroplasty in implant fixation: a 10-year follow-up of a randomized RSA trial.
Trial report in Acta orthopaedica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
background and purposeBicruciate-retaining (BCR) total knee arthroplasty (TKA) aims to restore physiological knee kinematics and joint stability by preserving both cruciate ligaments, potentially improving patient satisfaction. However, long-term clinical outcomes and tibial component migration remain insufficiently understood. We therefore aimed to evaluate long-term implant fixation and clinical outcome after BCR-TKA compared with cruciate-retaining (CR) TKA.
methodsWe performed a long-term follow-up of a randomized controlled trial using radiostereometric analysis (RSA) to compare tibial implant migration between BCR-TKA and CR-TKA. The primary outcome was maximum total point motion (MTPM) of the tibial component, measured with model-based RSA at 3 months, 1, 2, 5, and 10 years. Secondary outcomes included the Oxford Knee Score (OKS) and Forgotten Joint Score (FJS) at identical time points. Mortality, reoperations, and revisions were recorded.
results25 patients were included in each group. At 10 years, the estimated mean MTPM was 0.88 mm (95% confidence interval [CI] 0.64-1.12) in the BCR group and 0.64 mm (CI 0.40-0.88) in the CR group (between-group difference -0.23 mm, CI -0.57 to 0.10). Estimated changes in OKS and FJS showed no evidence of differing longitudinal trajectories between groups. 2 revisions occurred in the BCR group, whereas none occurred in the CR group.
conclusionNo significant differences were detected between BCR-TKA and CR-TKA in tibial implant migration or patient-reported outcomes over the 10-year follow-up. In contrast, the incidence of complications was higher in the BCR group, indicating that careful patient selection and optimization of surgical strategies remain important for BCR-TKA.
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