Anterior cruciate-retaining total knee arthroplasty

Fifty patients underwent bilateral total knee arthroplasty retaining both cruciate ligaments on one side and only the posterior cruciate ligament on the other. Patients were questioned about pain, instability, "feel," and ability to climb stairs. Seventy percent of patients stated that their anterior and posterior cruciate-retaining knee was their better knee overall. Ten percent stated that their posterior cruciate-only knee was better. Twenty percent could find no difference. There were no meaningful differences in inpatient care, physical therapy requirements, strength, range of motion, or component positioning. Fourteen patients handled stairs using each knee equally. Twenty-nine climbed stairs leading with the anterior and posterior cruciate-retaining knee and seven patients led with the posterior cruciate-only knee. Complaints of clunks, pops, and clicks occurred in 11 patients with posterior cruciate-only knee arthroplasties and in 4 patients retaining both anterior and posterior cruciate ligaments. Retaining the anterior cruciate ligament can provide a knee that subjectively "feels" better.