Biomimetic Total Knee Arthroplasty With Anterior Cruciate Ligament (ACL) Preservation Restores Normal Kinematics

INTRODUCTIONACL retaining (BCR) Total Knee Arthroplasty (TKA) provides more normal kinematics than ACL sacrificing (CR) TKA. However, in the native knee the ACL and the asymmetric shape of the tibial articular surface with a convex lateral plateau are responsible for the differential medial/lateral femoral rollback (medial pivot). Therefore, the hypothesis of this study was that an asymmetric biomimetic articular surface together with ACL preservation would better restore native knee kinematics than retention of the ACL alone. Normal knee kinematics from bi-planar fluoroscopy was used to reverse engineer the tibial articular surface of the biomimetic implant. This was achieved by moving the femoral component through the healthy knee kinematics and removing material from a tibial template.METHODSLifeModeler KneeSIM software was used to analyze a biomimetic BCR implant (asymmetric tibia with convex lateral surface), a contemporary BCR (symmetric shallow dished tibia) and a contemporary CR (symmetric dished ...