{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:30:01Z","timestamp":1793039401657,"version":"4.5.0"},"reference-count":20,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose:\u00a0Bicruciate-retaining (BCR) total knee arthroplasty (TKA) aims to restore physiological knee kinematics and joint stability by preserving both cruciate ligaments, potentially improving patient satisfaction. However, long-term clinical outcomes and tibial component migration remain insufficiently understood. We therefore aimed to evaluate long-term implant fixation and clinical outcome after BCR-TKA compared with cruciate-retaining (CR) TKA.Methods:\u00a0We performed a long-term follow-up of a randomized controlled trial using radiostereometric analysis (RSA) to compare tibial implant migration between BCR-TKA and CR-TKA. The primary outcome was maximum total point motion (MTPM) of the tibial component, measured with model-based RSA at 3 months, 1, 2, 5, and 10 years. Secondary outcomes included the Oxford Knee Score (OKS) and Forgotten Joint Score (FJS) at identical time points. Mortality, reoperations, and revisions were recorded.Results:\u00a025 patients were included in each group. At 10 years, the estimated mean MTPM was 0.88 mm (95% confidence interval [CI] 0.64\u20131.12) in the BCR group and 0.64 mm (CI 0.40\u20130.88) in the CR group (between-group difference \u22120.23 mm, CI \u22120.57 to 0.10). Estimated changes in OKS and FJS showed no evidence of differing longitudinal trajectories between groups. 2 revisions occurred in the BCR group, whereas none occurred in the CR group.Conclusion:\u00a0No significant differences were detected between BCR-TKA and CR-TKA in tibial implant migration or patient-reported outcomes over the 10-year follow-up. In contrast, the incidence of complications was higher in the BCR group, indicating that careful patient selection and optimization of surgical strategies remain important for BCR-TKA.<\/jats:p>","DOI":"10.2340\/17453674.2026.46805","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:05:22Z","timestamp":1789639522000},"source":"Crossref","is-referenced-by-count":1,"title":["Bicruciate-retaining versus cruciate-retaining total knee arthroplasty in implant fixation: a 10-year follow-up of a randomized RSA trial"],"prefix":"10.2340","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6469-4652","authenticated-orcid":false,"given":"Tomofumi","family":"Kinoshita","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8174-4965","authenticated-orcid":false,"given":"Kristian R L","family":"Mortensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2261-7709","authenticated-orcid":false,"given":"Lina H","family":"Ingelsrud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Muharemovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8114-5193","authenticated-orcid":false,"given":"Kirill","family":"Gromov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0132-8182","authenticated-orcid":false,"given":"Anders","family":"Troelsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"168450","doi-asserted-by":"crossref","unstructured":"Zhou C, Peng Y, An S, Bedair H, Li G. Does contemporary bicruciate retaining total knee arthroplasty restore the native knee kinematics? A descriptive literature review. Arch Orthop Trauma Surg 2022; 142(9): 2313-22. doi: 10.1007\/s00402-021-04116-3.","DOI":"10.1007\/s00402-021-04116-3"},{"key":"168451","doi-asserted-by":"crossref","unstructured":"Nishio Y, Onodera T, Kasahara Y, Takahashi D, Iwasaki N, Majima T. Intraoperative medial pivot affects deep knee flexion angle and patient-reported outcomes after total knee arthroplasty. J Arthroplasty 2014; 29(4): 702-6. doi: 10.1016\/j.arth.2013.06.035.","DOI":"10.1016\/j.arth.2013.06.035"},{"key":"168452","doi-asserted-by":"crossref","unstructured":"Dennis D A, Komistek R D, Mahfouz M R, Haas B D, Stiehl J B. Multicenter determination of in vivo kinematics after total knee arthroplasty. Clin Orthop Relat Res 2003; (416): 37-57. doi: 10.1097\/01.blo.0000092986.12414.b5.","DOI":"10.1097\/01.blo.0000092986.12414.b5"},{"key":"168453","doi-asserted-by":"crossref","unstructured":"Lavoie F, Al-Shakfa F, Moore J R, Mychaltchouk L, Iguer K. Postoperative stiffening after bicruciate-retaining total knee arthroplasty. J Knee Surg 2018; 31(5): 453-8. doi: 10.1055\/s-0037-1604145.","DOI":"10.1055\/s-0037-1604145"},{"key":"168454","doi-asserted-by":"crossref","unstructured":"Pelt C E, Sandifer P A, Gililland J M, Anderson M B, Peters C L. Mean three-year survivorship of a new bicruciate-retaining total knee arthroplasty: are revisions still higher than expected? J Arthroplasty 2019; 34(9): 1957-62. doi: 10.1016\/j.arth.2019.04.030.","DOI":"10.1016\/j.arth.2019.04.030"},{"key":"168455","doi-asserted-by":"crossref","unstructured":"Puijk R, Singh J, Puijk R H, Laende E K, Plevier J W M, Nolte P A, et al. Evaluation and refinement of thresholds for early migration of total knee replacements as an estimator of late aseptic loosening: an updated systematic review of RSA and survival studies. Acta Orthop 2025; 96: 1-10. doi: 10.2340\/17453674.2024.42574.","DOI":"10.2340\/17453674.2024.42574"},{"key":"168456","doi-asserted-by":"crossref","unstructured":"Pijls B G, Valstar E R, Nouta K A, Plevier J W, Fiocco M, Middeldorp S, et al. Early migration of tibial components is associated with late revision: a systematic review and meta-analysis of 21,000 knee arthroplasties. Acta Orthop 2012; 83(6): 614-24. doi: 10.3109\/17453674.2012.747052.","DOI":"10.3109\/17453674.2012.747052"},{"key":"168457","doi-asserted-by":"crossref","unstructured":"Troelsen A, Ingelsrud L H, Thomsen M G, Muharemovic O, Otte K S, Husted H. Are there differences in micromotion on radiostereometric analysis between bicruciate and cruciate-retaining designs in TKA? A randomized controlled trial. Clin Orthop Relat Res 2020; 478(9): 2045-53. doi: 10.1097\/CORR.0000000000001077.","DOI":"10.1097\/CORR.0000000000001077"},{"key":"168458","doi-asserted-by":"crossref","unstructured":"Hopewell S, Chan A W, Collins G S, Hr\u00f3bjartsson A, Moher D, Schulz K F, et al. CONSORT 2025 statement: updated guideline for reporting randomised trials. BMJ 2025; 389: e081123. doi: 10.1136\/bmj-2024-081123.","DOI":"10.1136\/bmj-2024-081123"},{"key":"168459","doi-asserted-by":"crossref","unstructured":"Kaptein B L, Pijls B, Koster L, K\u00e4rrholm J, Hull M, Niesen A, et al. Guideline for RSA and CT-RSA implant migration measurements: an update of standardizations and recommendations. Acta Orthop 2024; 95: 256-67. doi: 10.2340\/17453674.2024.40709.","DOI":"10.2340\/17453674.2024.40709"},{"key":"168460","doi-asserted-by":"crossref","unstructured":"Ryd L, Albrektsson B E, Carlsson L, Dansg\u00e5rd F, Herberts P, Lindstrand A, et al. Roentgen stereophotogrammetric analysis as a predictor of mechanical loosening of knee prostheses. J Bone Joint Surg Br 1995; 77(3): 377-83. PMID: 7744919","DOI":"10.1302\/0301-620X.77B3.7744919"},{"key":"168461","doi-asserted-by":"crossref","unstructured":"Beard D J, Harris K, Dawson J, Doll H, Murray D W, Carr A J, et al. Meaningful changes for the Oxford hip and knee scores after joint replacement surgery. J Clin Epidemiol 2015; 68: 73-9. doi:10.1016\/j.jclinepi.2014.08.009.","DOI":"10.1016\/j.jclinepi.2014.08.009"},{"key":"168462","doi-asserted-by":"crossref","unstructured":"Longo U G, De Salvatore S, Candela V, Berton A, Casciaro C, Sciotti G, et al. Unicompartmental knee arthroplasty: minimal important difference and patient acceptable symptom state for the Forgotten Joint Score. 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Clin Biomech (Bristol) 2025; 124: 106473. doi: 10.1016\/j.clinbiomech.2025.106473.","DOI":"10.1016\/j.clinbiomech.2025.106473"},{"key":"168466","doi-asserted-by":"crossref","unstructured":"Lavoie F, Denis A, Chergui S, Al-Shakfa F, Sabouret P. Bicruciate-retaining total knee arthroplasty non-inferior to posterior-stabilized prostheses after 5 years: a randomized, controlled trial. Knee Surg Sports Traumatol Arthrosc 2023; 31(3): 1034-42. doi: 10.1007\/s00167-022-07210-0.","DOI":"10.1007\/s00167-022-07210-0"},{"key":"168467","doi-asserted-by":"crossref","unstructured":"Kyriakidis T, Hernigou J, Pitsilos C, Verdonk R, Koulalis D. No clinical superiority of bi-cruciate retaining versus posterior stabilized total knee arthroplasty at two years follow-up. Acta Orthop Belg 2024; 90(3): 409-14. doi: 10.52628\/90.3.11905.","DOI":"10.52628\/90.3.11905"},{"key":"168468","doi-asserted-by":"crossref","unstructured":"Biazzo A, D\u2019Ambrosi R, Staals E, Masia F, Izzo V, Verde F. 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