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