97 / 242
Bicruciate-retaining TKA: A Concept Worth Exploring
97
alignment rods, coupled cutting blocks and,
importantly, an extra-articular tensioning
device [1]. His technique proved to be efficient
in obtaining identical rectangular extension
and flexion gaps. Also, as the AP femoral cuts
were made perpendicular to the mechanical
axis of the tibia, the femoral component was
serendipitously positioned in slight external
rotation, a concept that was not yet described
[15]. However, adopters of this technique
found it cumbersome and overly complex,
especially the extra-articular tensioning device.
This, combined with the increasing popularity
of simpler techniques involving cruciate
ligaments resection and independent cuts,
contributed greatly to the limited spread of the
concepts put forth by Cloutier among the
orthopedic community.
The technique of bicruciate-retaining knee
arthroplasty was recently revisited to make it
simpler while adhering to the same surgical
philosophy. In this new surgical method, the
extra-articular tensioning device is replaced by
a system of spacer blocks (fig. 1). The surgical
sequence was modified and is detailed in
Figure 2. This technique consistently results in
Fig. 2: Revisited bicruciate-retaining TKA surgical
sequence.
Fig. 1: Revisited surgical technique : Cloutier’s
extra-articular tensioner was replaced by a system
of spacer blocks ans shims.