{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T17:49:02Z","timestamp":1782928142013,"version":"3.54.5"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Orthop Surg Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Bicruciate-retaining (BCR) total knee arthroplasty (TKA) was developed to better replicate native knee biomechanics by preserving both cruciate ligaments. First-generation BCR implants were notorious for technical challenges and suboptimal survivorship. However, advancements in implant design and surgical techniques have renewed interest in second-generation BCR TKA systems. This study aimed to evaluate the overall survivorship of contemporary (second-generation) BCR primary TKA implants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic review of PubMed, Scopus, Embase, Web of Science, and Cochrane databases was conducted from inception to January 3, 2025. Inclusion criteria were studies that reported the number of revisions following second-generation BCR TKA. We excluded case reports, review articles, and studies that evaluated first-generation BCR TKA. A total of 1046 articles were retrieved; ultimately, 13 were included. Events per person-years pooled analysis was performed to estimate the incidence of all-cause revision, adjusting for duration of follow-up. Heterogeneity was measured using I\n                      <jats:sup>2<\/jats:sup>\n                      test. A\n                      <jats:italic>p<\/jats:italic>\n                      -value\u2009&lt;\u20090.05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1,087 BCR TKA implants among 13 studies were analyzed. The mean follow-up was 2.6 years. A total of 62 (5.7%) knees were revised. The overall pooled rate of all-cause revision was 1.6 per 100 person-years (95% confidence interval [CI] 0.009\u20130.023) Heterogeneity among the analyzed studies was significant (I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200975.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Contemporary BCR TKA implants showed improved survivorship compared to historical reports, with a low pooled all-cause revision rate of 1.6 per 100 person-years, corresponding to a 1.6% chance of revision per year of follow-up. Despite the associated heterogeneity, these findings suggest that modern BCR designs offer durable outcomes and support their continued use. Further long-term comparative data are needed to better define their role relative to modern knee implants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00590-026-04811-0","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T17:13:17Z","timestamp":1782925997000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Contemporary bicruciate-retaining total knee arthroplasty implants demonstrate favorable survivorship: a systematic review and meta-analysis of 1576 knees"],"prefix":"10.1007","volume":"36","author":[{"given":"Varun","family":"Kompala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled A.","family":"Elmenawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maile","family":"Wedgwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Islam A.","family":"Sherif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loren","family":"Hackett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Adolph V.","family":"Lombardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas S.","family":"Piuzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"4811_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2025.05.124","author":"CM Jones","year":"2025","unstructured":"Jones CM, Potluri AS, Federico VP, Nie JW, Forlenza EM, Serino J et al (2025) Trends in Medicare Arthroplasty Procedure Volume:Projecting from 2025 to 2040. 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Piuzzi, MD reports being a paid consultant for Stryker, Pacira, and Zimmer. He holds stock or stock options in Osteal Therapeutics and has received research support as a principal investigator from Osteal Therapeutics, Peptilogics, RegenLab, Signature Orthopedics, Zimmer, and Stryker. He serves on the editorial board of The Journal of Bone and Joint Surgery and holds board or committee appointments with the American Association of Hip and Knee Surgeons and the Orthopaedic Research Society. He reports no royalties, speaker bureau participation, employment relationships, unpaid consultancies, or other financial or material support. Adolph V. Lombardi Jr., MD, FACS reports receiving royalties from Zimmer Biomet and Innomed and serving as a paid consultant for Zimmer Biomet. He holds minority stock interests in JIS Ventures, Joint Development Corporation, Prescribe Fit, and Parvizi Surgical Innovation. He has received research support as a principal investigator from Zimmer Biomet, Total Joint Orthopedics, Firstkind, Parvizi Surgical Innovations Research Institute, Recovery Rx, SPR Therapeutics, Prescribe Fit, Smith & Nephew, S-I Bone, Hip Innovation Technology, Medacta, and Elute, Inc. He serves on the editorial or governing boards of multiple journals, including The Journal of Arthroplasty, The Journal of Bone and Joint Surgery, Clinical Orthopaedics and Related Research, The Journal of the American Academy of Orthopaedic Surgeons, Journal of Orthopaedics and Traumatology, Surgical Technology International, The Knee, and The Bone & Joint Journal. He also holds board or committee roles with Operation Walk USA, Central Ohio Orthopaedic Management Company, and Current Concepts in Joint Replacement. He reports no speaker bureau participation, employment relationships, unpaid consultancies, or other financial or material support. The remaining authors have nothing to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}}],"article-number":"268"}}