Bicruciate retaining arthroplasty

Total knee arthroplasty (TKA) is one of the most successful orthopaedic procedures with 10 to 20 year survivorships from multiple studies of greater than 95%. These success rates typically apply to patients over 70 years of age who may only want to return to activities of daily living. However, recently there is a demand by both senior citizens as well as young patients to have TKAs that return them to high activity levels and occasionally high performance sports. In this review, we will describe bicruciate retaining prostheses, including knowledge of their kinematics from fluoroscopic and gait studies, results of clinical studies, a summary of their potential advantages and disadvantages, anterior cruciate ligament viability at time of arthroplasty, considerations for implantation of these devices, and their role in the future of total knee arthroplasty.