Patients prefer a bicruciate-retaining or the medial pivot total knee prosthesis

Four-hundred forty patients underwent staged bilateral total knee arthroplasty using a different prosthesis on each side. Prostheses used were anterior-posterior cruciate-retaining (ACL-PCL), posterior cruciate-retaining (PCL), Medial Pivot (MP), posterior cruciate-substituting (PS), and mobile bearing (MB). At the 2-year evaluation, we asked "Which is your better knee overall?" Responses were as follows: 89.1% preferred the ACL-PCL to the PS and 76.2% preferred the MP to the PS. The ACL-PCL and the MP were preferred equally. The MP was preferred over the PCL by 76.0%, and 61.4% preferred the MP over the MB. The PS and PCL were preferred equally. Range of motion, pain relief, alignment, and stability did not vary significantly by prosthesis used. Patients with bilateral total knee arthroplasties preferred retention of both cruciates with use of the ACL-PCL prosthesis or substituting with an MP prosthesis.