title: Macroscopic evaluation of the anterior cruciate ligament in osteoarthritic patients undergoing total knee arthroplasty.
abstract: BACKGROUND
  Sacrifice of the anterior cruciate ligament (ACL) is currently common practice during total knee arthroplasty (TKA). However, patients who receive an ACL-retaining TKA maintain more normal knee kinematic patterns than those without an ACL. Additionally, satisfactory survival and function more than 20 years after bicruciate-retaining TKA has recently been reported. The purpose of this study was to compare the percentage of knees with a visually intact ACL prior to TKA surgery with previously reported values.
  
  
  METHODS
  A total of 247 knees (216 consecutive patients) that underwent TKA were retrospectively evaluated. The preoperative diagnosis for all patients was primary OA. The macroscopic appearance of the ACL at the time of surgery was retrospectively assessed using routinely recorded digital photographs and classified as normal, moderately damaged (fissured), or completely ruptured. Both normal and moderately damaged ACLs were defined as intact.
  
  
  RESULTS
  Ninety-four percent (233/247) of the knees had an intact ACL (normal or moderately damaged). This value is higher than that found in previous reports.
  
  
  CONCLUSIONS
  Our results show more candidates for bicruciate ligament-retaining TKA surgery than reported previously. This suggests that improved techniques for bicruciate-retaining TKA would be clinically useful and could benefit a large number of patients.
authors.affiliation: Ishii Orthopaedic and Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan. ishii@sakitama.or.jp.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ishii
authors.affiliation: Ishii Orthopaedic and Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Noguchi
authors.affiliation: Ishii Orthopaedic and Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Sato
authors.affiliation: Ishii Orthopaedic and Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Ishii Orthopaedic and Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takayama
authors.affiliation: Division of Information Science and Biostatistics, Niigata University Graduate School of Medical and Dental Sciences, 1 Asahimachi Dori Niigata, Niigata, 951-8520, Japan.
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Toyabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016118:Anterior Cruciate Ligament / Q000473:pathology* / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies
keywords: ACL; Bicruciate-retaining; Kinematics; Osteoarthritic knee; TKA