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ACL Damage and Deficiency is Associated with More Severe Preoperative Deformity, Lower Range of Motion at the Time of TKA

  • Original Article
  • Published:
HSS Journal ®

Abstract

Background

ACL status varies in the arthritic knee during TKA.

Questions/Purposes

The purpose of this study was to examine clinical features and intraoperative findings associated with stages of ACL degeneration.

Methods

Coronal deformity, ROM, intra-articular degenerative patterns, and ligament releases were assessed for 1656 knees during TKA. Common patterns of deformity and severity of degenerative change were assessed as a function of the severity of ACL deficiency.

Results

Of the 1656 knees assessed, 27% had a normal ACL, 55% exhibited damage, and 18% exhibited complete absence of the ACL. Increased coronal deformity and lower preoperative ROM was associated with ACL deficiency. Increased chondral and meniscal damage and more extensive osteophyte formation were also found. More extensive ligament releases were required in ACL-deficient knees.

Conclusions

The status of the ACL is predictive of the need for increased surgical deformity correction. A better understanding of ACL status is an important consideration during in choosing TKA as opposed to unicompartmental arthroplasty. The status of the ACL should be considered in planning for implant choice in TKA.

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Acknowledgments

This work was performed with the support of Joint Replacement Surgeons of Indiana Research Foundation.

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Authors and Affiliations

  1. Center for Hip and Knee Surgery, 1199 Hadley Road, Mooresville, Indiana, 46158, USA

    Michael E. Berend MD, John B. Meding MD, Robert A. Malinzak MD, Philip M. Faris MD, Michael D. Jackson, Kenneth E. Davis MS & Merrill A. Ritter MD

  2. Joint Replacement Surgeons of Indiana Research Foundation, Center for Hip and Knee Surgery, 1199 Hadley Road, Mooresville, Indiana, 46158, USA

    Merrill A. Ritter MD

Authors
  1. Michael E. Berend MD
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  2. John B. Meding MD
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  3. Robert A. Malinzak MD
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  4. Philip M. Faris MD
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  5. Michael D. Jackson
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  6. Kenneth E. Davis MS
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  7. Merrill A. Ritter MD
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Corresponding author

Correspondence to Merrill A. Ritter MD.

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Conflict of Interest

Michael E. Berend, MD, John B. Meding, MD, Michael D. Jackson and Kenneth E. Davis MS have declared that they have no conflict of interest. Philip M. Faris, MD reports grants from Biomet, Inc, during the conduct of the study. Merrill A. Ritter, MD reports grants from Biomet, Inc, during the conduct of the study; personal fees from Iconacy Orthopaedic Implants, LLC, outside the work. Robert A. Malinzak, MD reports grants from Biomet, Inc, during the conduct of the study. John B. Meding, MD reports grants from Biomet, Inc, during the conduct of the study; personal fees from Biomet, Inc, outside the work.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent

Informed consent was waived from all patients for being included in the study.

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Disclosure forms provided by the authors are available with the online version of this article.

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Level of Evidence

Therapeutic Study Level IV

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Berend, M.E., Meding, J.B., Malinzak, R.A. et al. ACL Damage and Deficiency is Associated with More Severe Preoperative Deformity, Lower Range of Motion at the Time of TKA. HSS Jrnl 12, 235–239 (2016). https://doi.org/10.1007/s11420-016-9504-x

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  • DOI: https://doi.org/10.1007/s11420-016-9504-x

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