Total knee replacement (TKR) is a procedure used to treat knee arthropathy. Patients' dissatisfaction is still relevant (literature reports dissatisfaction rates as high as 40%). The anterior cruciate ligament is usually removed while performing a total knee arthroplasty, thus changing knee biomechanics. As patients' mean age to surgery is decreasing, bicruciate retaining models, which preserve normal biomechanics, may be useful in increasing patients' outcomes. Limited data concerning bicruciate retaining arthroplasty is available; although clinical results are encouraging, there are concerns regarding surgical exposure, anterior cruciate integrity evaluation, and implant fixation.