Combined unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction in knees with osteoarthritis and deficient anterior cruciate ligamentReport as inadecuate




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BMC Musculoskeletal Disorders

, 17:327

Orthopedics and biomechanics

Abstract

BackgroundRelative young and more active patients with osteoarthritis OA of the isolated medial femorotibial compartment in conjunction with anterior cruciate ligament ACL deficiency are difficult to treat. The aim of this study was to explore the early clinical outcomes of combined Oxford unicompartmental knee arthroplasty UKA and ACL reconstruction for the patients presenting ACL deficiency and isolated OA of the medial compartment.

MethodsTwenty-eight patients were included into the study. All patients were treated by combined Oxford UKA and ACL reconstruction. Plain radiographs in the antero-posterior and lateral view and long-leg standing radiographs were routinely performed prior to and after surgery. Stress radiographs in valgus were additionally available in order to verify the well-preserved lateral compartment. The varus deformity of the knee prior to surgery and the valgus degree after surgery, the posterior slope of the tibial component and the range of motion ROM of the knee after surgery were measured and recorded. Clinical evaluations include Oxford Knee Score OKS, Knee Society Score KSS-clinical score; KSS-function score and Tegner activity score.

ResultsAll the patients were followed up for 52 ± 8 months. The leg alignment showed 3.1 ± 0.6° of varus deformity prior to surgery and 4.0 ± 0.7° of valgus after surgery. The OKS, KSS and Tegner activity score improved significantly after surgery P < 0.05. The mean ROM of the operated knee was 123.5 ± 2.8° at the last follow-up. The posterior slope of the tibial component was 3.9 ± 1.2°. A significant correlation was found between them according to the Pearson’s correlation r = 0.39, P = 0.03. There were 2 patients 7 % with the complication of mobile bearing dislocation, and a second operation of replacing a thicker mobile bearing was performed for them.

ConclusionThe early clinical data have shown that combined surgery of UKA and ACL reconstruction has revealed promising results. However, long-term follow-up studies should be done in these patients.

Trial registrationCurrent trial ISRCTN24663935 Retrospectively registered on 21 July 2016.

KeywordsOsteoarthritis Knee Anterior cruciate ligament reconstruction Unicompartmental knee arthroplasty Oxford III prosthesis Clinical outcomes  Download fulltext PDF



Author: Shaoqi Tian - Bin Wang - Yuanhe Wang - Chengzhi Ha - Lun Liu - Kang Sun

Source: https://link.springer.com/







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