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J Knee Surg 2020; 33(11): 1152-1156
DOI: 10.1055/s-0039-1692647
Original Article

Unicompartmental Knee Replacement Combined to Anterior Cruciate Ligament Reconstruction: Midterm Results

Authors

  • Alberto Ventura

    1   IRCCS Istituto Ortopedico Galeazzi, Sport Traumatology and Minimally Invasive Articular Surgery Center, Milano, Italy

  • Claudio Legnani 

    1   IRCCS Istituto Ortopedico Galeazzi, Sport Traumatology and Minimally Invasive Articular Surgery Center, Milano, Italy

  • Clara Terzaghi

    2   Istituto Clinico Villa Aprica, Department of Orthopaedics, Como, Italy

  • Vittorio Macchi

    1   IRCCS Istituto Ortopedico Galeazzi, Sport Traumatology and Minimally Invasive Articular Surgery Center, Milano, Italy

  • Enrico Borgo

    1   IRCCS Istituto Ortopedico Galeazzi, Sport Traumatology and Minimally Invasive Articular Surgery Center, Milano, Italy

Funding This research was supported by the Italian Ministry of Health.
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Abstract

A study was conducted to retrospectively evaluate the outcomes of combined medial unicompartmental knee replacement (UKR) and anterior cruciate ligament (ACL) reconstruction. The hypothesis was that this procedure would lead to satisfying results in patients affected by medial osteoarthritis and ACL insufficiency. Fourteen patients with ACL deficiency and concomitant medial compartment symptomatic osteoarthritis were treated from 2006 to 2010. Twelve of them were followed-up for an average time of 7.8 year (range: 6–10 years). Assessment included Knee Osteoarthritis Outcome score (KOOS), Oxford Knee score (OKS), American Knee Society scores (AKSS), Western Ontario and McMaster (WOMAC) index of osteoarthritis, Tegner's activity level, objective examination including instrumented laxity test with KT-1000 arthrometer, and standard X-rays. KOOS score, OKS, WOMAC index, and the AKSS improved significantly at follow-up (p < 0.001). There was no clinical evidence of instability in any of the knees as evaluated with clinical and instrumented laxity testing (p < 0.001). No pathologic radiolucent lines were observed around the components. In one patient, a total knee prosthesis was implanted due to the progression of signs of osteoarthritis in the lateral compartment 3 years after primary surgery. UKR combined with ACL reconstruction is an effective therapeutic option for the treatment of combined medial unicompartmental knee osteoarthritis and ACL deficiency and confirms subjective and objective clinical improvement up to 8 years after surgery. This study reflects level IV evidence.

Keywords

unicompartmental knee replacement - medial osteoarthritis - anterior cruciate ligament - ACL reconstruction


Publication History

Received: 09 March 2018

Accepted: 05 May 2019

Article published online:
03 July 2019

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