Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 21, Issue 11, pp 2480–2486 | Cite as

No difference in survivorship after unicompartmental knee arthroplasty with or without an intact anterior cruciate ligament

  • Adam Boissonneault
  • Hemant PanditEmail author
  • Elise Pegg
  • Cathy Jenkins
  • Harinderjit Singh Gill
  • Christopher A. F. Dodd
  • Christopher L. M. H. Gibbons
  • David W. Murray



Anterior cruciate ligament deficiency (ACLD) has been considered a contraindication for Oxford unicompartmental knee arthroplasty (UKA) because of the reported higher incidence of failure when implanted in ACLD knees. However, given the potential advantages of UKA over total knee arthroplasty (TKA), we have performed UKA in a limited number of patients with ACL deficiency and end-stage medial compartment osteoarthritis (OA) over the past 11 years. The primary aim of this study was to establish the clinical outcome of this cohort; the secondary aim was to compare both clinical and radiographic data with a matched cohort of ACL-intact (ACLI) patients who have undergone UKA for anteromedial OA.


This retrospective observational study describes the clinical and radiological outcome in 46 medial Oxford UKAs implanted in 42 consecutive patients with ACL deficiency and concomitant symptomatic medial compartment OA at mean follow-up of 5 years. It also compares the outcomes with a matched cohort of UKA patients with an intact ACL (ACLI group).


At the time of last follow-up, there was no significant difference in clinical results or survivorship between the two groups in this study.


The successful short-term results of the ACLD group suggest ACL deficiency may not always be a contraindication to Oxford UKA as previously thought. Until long-term data is available, however, we maintain our recommendation that ACLD be considered a contraindication.

Level of evidence



Unicompartmental knee arthroplasty Anterior cruciate ligament deficiency Contraindications Implant survival 


  1. 1.
    Cardillo G (2008) KMPLOT: Kaplan-Meier estimation of the survival function
  2. 2.
    Cartier P, Sanouiller JL, Greslamer RP (1996) Unicompartmental knee arthroplasty surgery. 10-year minimum follow-up period. J Arthroplasty 11:782–788PubMedCrossRefGoogle Scholar
  3. 3.
    Christensen NO (1991) Unicompartmental prosthesis for gonarthrosis. A nine-year series of 575 knees from a Swedish hospital. Clin Orthop Relat Res 273:165–169PubMedGoogle Scholar
  4. 4.
    Dawson J, Fitzpatrick R, Murray DW, Carr AJ (1998) Questionnaire on the perceptions of patients about total knee arthroplasty. J Bone Joint Surg [Br] 80-B:63–69CrossRefGoogle Scholar
  5. 5.
    Deschamps G, Lapeyre B (1987) Rupture of the anterior cruciate ligament: a frequently unrecognized cause of failure of unicompartmental knee prostheses. Apropos of a series of 79 Lotus prostheses with a follow-up of more than 5 years. Rev Chir Orthop Reparatrice Appar Mot 73:544–551PubMedGoogle Scholar
  6. 6.
    Engh GA, Ammeen D (2004) Is an intact anterior cruciate ligmament needed in order to have a well-functioning unicondylar knee arthroplasty? Clin Orthop Relat Res 428:170–173PubMedCrossRefGoogle Scholar
  7. 7.
    Goodfellow JW, Kershaw CJ, D’A Benson MK, O’Connor JJ (1988) The Oxford knee for unicompartmental osteoarthritis: the first 103 cases. J Bone Joint Surg [Br] 70-B:692–701Google Scholar
  8. 8.
    Harmen MK, Markovich GD, Banks SA, Hodge WA (1998) Wear patterns on tibial plateaus from varus and valgus osteoarthritic knees. Clin Orthop Relat Res 352:149–158Google Scholar
  9. 9.
    Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMedGoogle Scholar
  10. 10.
    Jacobsen K (1981) Gonylaxometry. Stress radiographic measurement of passive stability in the knee joints of normal subjects and patients with ligament injuries: accuracy and range of application. Acta Orthop Scand [Suppl] 52(194):1–263Google Scholar
  11. 11.
    Kendrick BJ, Rout R, Bottomley NJ, Pandit H, Gill HS, Price AJ, Dodd CAF, Murray DW (2010) The implications of damage to the lateral femoral condyle on medial unicompartmental knee arthroplasty. J Bone Joint Surg [Br] 92-B:374–379Google Scholar
  12. 12.
    Keyes GW, Carr AJ, Miller RK, Goodfellow JW (1992) The radiographic classification of medial gonarthrosis. Acta Orthop Scand 63(5):497–501PubMedCrossRefGoogle Scholar
  13. 13.
    Lee G, Cushner FD, Vigoritta V, Scuderi GR, Insall JN, Scott NS (2005) Evaluation of the anterior cruciate ligament integrity and degenerative arthritic patterns in patients undergoing total knee arthroplasty. J Arthroplasty 20:59–65PubMedCrossRefGoogle Scholar
  14. 14.
    Mullaji AB, Marawar SV, Luthra M (2008) Tibial articular cartilage wear in varus osteoarthritic knees: correlation with anterior cruciate ligament integrity and severity of deformity. J Arthroplasty 23:128–135PubMedCrossRefGoogle Scholar
  15. 15.
    Murray DW (2000) Unicompartmental knee arthroplasty: now or never? Orthopedics 23(9):979–980PubMedGoogle Scholar
  16. 16.
    Pandit H, Beard J, Jenkins C, Kimstra Y, Thomas NP, Dodd CAF, Murray DW (2006) Combined anterior cruciate reconstruction and Oxford unicompartmental knee arthoplasty. J Bone Joint Surg [Br] 88-B:887–892Google Scholar
  17. 17.
    Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49PubMedGoogle Scholar
  18. 18.
    Tibrewal SB, Grant KA, Goodfellow JW (1984) The radiolucent line beneath the tibial components of the Oxford meniscal knee. J Bone Joint Surg [Br] 66-B:523–528Google Scholar
  19. 19.
    White SH, Ludkowski PF, Goodfellow JW (1991) Anteromedial osteoarthritis of the knee. J Bone Joint Surg [Br] 73-B:582–586Google Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Adam Boissonneault
    • 1
  • Hemant Pandit
    • 1
    • 2
    Email author
  • Elise Pegg
    • 1
  • Cathy Jenkins
    • 2
  • Harinderjit Singh Gill
    • 1
  • Christopher A. F. Dodd
    • 2
  • Christopher L. M. H. Gibbons
    • 2
  • David W. Murray
    • 1
    • 2
  1. 1.Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)University of OxfordHeadington, OxfordUK
  2. 2.Nuffield Orthopaedic Centre (NOC)University of OxfordHeadington, OxfordUK

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