Combined anterior cruciate reconstruction and Oxford unicompartmental knee arthroplasty
- 1 July 2006
- journal article
- Published by British Editorial Society of Bone & Joint Surgery in The Journal of Bone and Joint Surgery. British volume
- Vol. 88-B (7), 887-892
- https://doi.org/10.1302/0301-620x.88b7.17847
Abstract
The options for treatment of the young active patient with isolated symptomatic osteoarthritis of the medial compartment and pre-existing deficiency of the anterior cruciate ligament are limited. The potential longevity of the implant and levels of activity of the patient may preclude total knee replacement, and tibial osteotomy and unicompartmental knee arthroplasty are unreliable because of the ligamentous instability. Unicompartmental knee arthroplasties tend to fail because of wear or tibial loosening resulting from eccentric loading. Therefore, we combined reconstruction of the anterior cruciate ligament with unicompartmental arthroplasty of the knee in 15 patients (ACLR group), and matched them with 15 patients who had undergone Oxford unicompartmental knee arthroplasty with an intact anterior cruciate ligament (ACLI group). The clinical and radiological data at a minimum of 2.5 years were compared for both groups. The groups were well matched for age, gender and length of follow-up and had no significant differences in their pre-operative scores. At the last follow-up, the mean outcome scores for both the ACLR and ACLI groups were high (Oxford knee scores of 46 (37 to 48) and 43 (38 to 46), respectively, objective Knee Society scores of 99 (95 to 100) and 94 (82 to 100), and functional Knee Society scores of 96 and 96 (both 85 to 100). One patient in the ACLR group needed revision to a total knee replacement because of infection. No patient in either group had radiological evidence of component loosening. The radiological study showed no difference in the pattern of tibial loading between the groups. The short-term clinical results of combined anterior cruciate ligament reconstruction and unicompartmental knee arthroplasty are excellent. The previous shortcomings of unicompartmental knee arthroplasty in the presence of deficiency of the anterior cruciate ligament appear to have been addressed with the combined procedure. This operation seems to be a viable treatment option for young active patients with symptomatic arthritis of the medial compartment, in whom the anterior cruciate ligament has been ruptured.Keywords
This publication has 24 references indexed in Scilit:
- Oxford medial unicompartmental knee arthroplasty in patients younger and older than 60 years of ageThe Journal of Bone and Joint Surgery. British volume, 2005
- Ten-year in vivo wear measurement of a fully congruent mobile bearing unicompartmental knee arthroplastyThe Journal of Bone and Joint Surgery. British volume, 2005
- Anterior Cruciate Ligament Reconstruction and the Long Term Incidence of GonarthrosisSports Medicine, 1999
- The Oxford medial unicompartmental arthroplastyThe Journal of Bone and Joint Surgery, 1998
- The Anterior Cruciate Ligament in Knee ArthroplastyClinical Orthopaedics and Related Research, 1992
- The radiographic classification of medial gonarthrosisActa Orthopaedica, 1992
- Rationale, of The Knee Society Clinical Rating SystemClinical Orthopaedics and Related Research, 1989
- The orientation of the distal part of the quadriceps femoris muscle as a function of the knee flexion-extension angleJournal of Biomechanics, 1985
- Rating Systems in the Evaluation of Knee Ligament InjuriesClinical Orthopaedics and Related Research, 1985
- The Untreated Anterior Cruciate Ligament RupturePublished by Wolters Kluwer Health ,1983