Our Summary

This research paper is about a type of knee replacement surgery called Bi-cruciate retaining total knee prostheses (BCR TKA), where the anterior cruciate ligament (ACL) is kept in place. This method was designed to create a more natural movement in the knee after surgery.

The researchers did a deep dive into previous studies on BCR TKA to see when it’s used and what the results were. They found that it’s often used for conditions like osteoarthritis and inflammatory arthritis.

The studies they looked at had a range of results. Some knee replacements were still working well after 22 years, while others had to be adjusted or replaced after just 18 months. There was no clear reason for these differences. It could be down to the design of the replacement, the way the surgery was performed, or personal factors like what the patient expected or how much they used their knee.

Right now, there’s no clear guidance on when to use BCR implants. However, the researchers believe the results could be improved with better designs. They suggest that more studies are needed to prove the effectiveness of newer BCR TKA designs.

FAQs

  1. What is Bi-cruciate retaining total knee prostheses (BCR TKA) and why was it designed?
  2. What conditions is the BCR TKA often used for?
  3. Why are there differences in the durability of knee replacements using BCR TKA?

Doctor’s Tip

A helpful tip a doctor might give a patient about knee replacement surgery, including BCR TKA, is to follow the post-operative rehabilitation plan diligently. This typically includes physical therapy and exercises to strengthen the muscles around the knee, improve range of motion, and aid in the recovery process. It’s important to do these exercises as instructed by the healthcare team to ensure a successful outcome and maximize the benefits of the knee replacement surgery.

Suitable For

Overall, patients who are recommended for knee replacement surgery, including BCR TKA, typically have severe knee pain and disability that is not improving with non-surgical treatments such as physical therapy, medications, or injections. They may have conditions such as osteoarthritis, inflammatory arthritis, or previous injuries that have led to significant damage to the knee joint.

Patients who are younger and more active may also be considered for knee replacement surgery, as they may benefit from the improved range of motion and function that a knee replacement can provide. However, it is important to carefully consider the risks and benefits of surgery in these patients, as they may have a higher chance of needing revision surgery in the future.

Ultimately, the decision to undergo knee replacement surgery, including BCR TKA, should be made in consultation with a healthcare provider who can assess the individual patient’s condition, goals, and overall health to determine the most appropriate treatment option.

Timeline

Before knee replacement surgery, a patient may experience chronic knee pain, stiffness, swelling, and limited mobility. They may have tried various conservative treatments such as physical therapy, medication, and injections without success.

After knee replacement surgery, the patient will undergo a period of rehabilitation and physical therapy to regain strength, flexibility, and range of motion in the knee. This process can take several weeks to months, depending on the individual’s progress. Eventually, most patients experience reduced pain, improved mobility, and a better quality of life. However, some patients may still require further adjustments or revisions to their knee replacement in the future.

Overall, the timeline for a patient before and after knee replacement surgery can vary, but the goal is to ultimately improve their quality of life and ability to move without pain.

What to Ask Your Doctor

  1. What are the potential benefits of BCR TKA compared to traditional knee replacement surgery?

  2. What are the potential risks and complications associated with BCR TKA?

  3. How long does the recovery process typically take for BCR TKA compared to traditional knee replacement surgery?

  4. What factors determine if I am a good candidate for BCR TKA?

  5. How many BCR TKA surgeries have you performed, and what is your success rate with this procedure?

  6. What type of rehabilitation or physical therapy will be necessary after BCR TKA surgery?

  7. What is the expected lifespan of a BCR TKA implant, and what factors can affect its longevity?

  8. Are there any restrictions or limitations on physical activity after BCR TKA surgery?

  9. What should I expect in terms of pain management following BCR TKA surgery?

  10. Are there any alternative treatments or procedures that I should consider before opting for BCR TKA surgery?

Reference

Authors: Boese CK, Ebohon S, Ries C, De Faoite D. Journal: Arch Orthop Trauma Surg. 2021 Feb;141(2):293-304. doi: 10.1007/s00402-020-03622-0. Epub 2020 Oct 13. PMID: 33047230