Preservation of anterior cruciate ligament in total knee arthroplasty

Few prostheses allow preservation of the anterior cruciate ligament (ACL) during total knee replacement. We report a short-term, prospective, open study of 32 ACL-retaining and 93 ACL-replacing total knee replacements and compare the respective outcomes of both prosthesis types with a follow-up time of 2-3 years. Mean operative time, complication or revision rates did not differ, nor did the early and late clinical and radiological evaluations. This study does not support the suggestion that technical difficulties increase for ACL preservation. The clinical and functional results were neither improved nor worsened for ACL-retaining prostheses. There is thus no advantage, but also no inconvenience, in retaining the ACL according to short- to mid-term results of a gliding posterior cruciate ligament (PCL)-retaining prosthesis with ACL-replacement design. The possibility of an improved long-term outcome of an ACL-retaining prosthesis should be investigated further.