Long-term deterioration after one-stage unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction
- 40 Downloads
Treatment for unicompartmental knee osteoarthritis (OA) is controversial in young patients with concomitant anterior cruciate ligament (ACL) deficiency. The aim of the current study is to report long-term results after the combination of unicompartmental knee arthroplasty (UKA) and ACL reconstruction.
Retrospective study of one-stage medial UKA and ACL reconstruction was performed on eight patients at a mean age of 52 years (42–60). Clinical and radiological results were assessed and analyzed after a mean follow-up of 14.6 years.
Patients were satisfied and mean personal satisfaction rate was 8.8 (4–10). At the last follow-up, mean WOMAC score was 26 (1–52) and mean global KSS was 154 (102–200). One revision surgery to total knee arthroplasty was performed 9 years after the combined procedure due to aseptic loosening. One more case of clinical deterioration was observed 13 years after index surgery.
Combined UKA and ACL reconstruction can be a therapeutic option for young and active patients with concomitant knee instability and unicompartmental OA. The procedure is highly demanding and reliable only in hands of experienced surgeons. Overall, satisfactory outcome can be achieved at a minimum follow-up of 10 years. However, clinical deterioration can be observed in the long term.
KeywordsUKA ACL reconstruction One stage Long term
Support for statistical analysis was provided by Luis I. Martínez. Language edition was performed by Toby D. Howick.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
Outside the submitted work, Dr. J. F. Aragón reports personal fees and non-financial support from the Smith & Nephew company. The rest of authors declare that they have no conflict of interest.
Statement of human rights
This study was carried out at the Fundació Hospital de l’Esperit Sant (Santa Coloma de Gramenet, Spain) and was approved by the institutional review board and ethical committee of the United Catalonian Hospitals Foundation (Barcelona, Spain), with the code CEIC 15/102. All procedures performed in these studies were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
All patients were informed about the study and gave informed consent to the work. No dead patient was included in the study.
- 2.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 73:544–551 (in French) PubMedGoogle Scholar
- 3.Christensen NO (1991) Unicompartmental prosthesis for gonarthrosis. A nine-year series of 575 knees from a Swedish hospital. Clin Orthop 273:165–169Google Scholar
- 6.Weston-Simons JS, Pandit H, Jenkins C et al (2012) Outcome of combined unicompartmental knee replacement and combined or sequential anterior cruciate ligament reconstruction: a study of 52 cases with mean follow-up of five years. J Bone Joint Surg Br 94(9):1216–1220. https://doi.org/10.1302/0301-620X.94B9.28881 CrossRefPubMedGoogle Scholar
- 17.Lee YS, Yun JY, Lee BK (2014) Tibial component coverage based on bone mineral density of the cut tibial surface during unicompartmental knee arthroplasty: clinical relevance of the prevention of tibial component subsidence. Arch Orthop Trauma Surg 134(1):85–89. https://doi.org/10.1007/s00402-013-1895-2 CrossRefPubMedGoogle Scholar
- 20.Järvenpää J, Kettunen J, Miettinen H, Kröger H (2010) The clinical outcome of revision knee replacement after unicompartmental knee arthroplasty versus primary total knee arthroplasty: 8–17 years follow-up study of 49 patients. Int Orthop 34(5):649–653. https://doi.org/10.1007/s00264-009-0811-4 CrossRefPubMedGoogle Scholar