Function of the anterior cruciate ligament after unicompartmental knee arthroplasty

Suggs, Jeremy F.; Li, Guoan; Park, Sang Eun; Steffensmeier, S. J.; Rubash, Harry E.; Freiberg, Andrew A.

doi:10.1016/j.arth.2003.08.018

Cited by 57 publications

(55 citation statements)

References 25 publications

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“…They all had intact anterior cruciate ligament and without significant deformity (varus malalignment less than 15 , valgus malalignment less than 10 , fixed flexion deformity of less than 5 and flexion more than 90…”

Section: Methodsmentioning

confidence: 99%

“…4 Furthermore, preservation of the anterior and posterior cruciate ligaments with intact patellofemoral joint (PFJ) and meniscus may allow the operated knee mimicking near normal knee kinetics. 5,6 Despite having such reported advantages, patients who underwent UKA surgery were known to have a higher risk of revision as compared to patients who had TKA surgery. those who were older than 60 years with low physical demand, minimum rest pain, preoperative arc of flexion of at least 90 , flexion contracture of less than 5 , limited angular deformity, intact anterior cruciate ligaments, no OA in the contralateral compartment and no patellofemoral pain.…”

Section: Introductionmentioning

confidence: 99%

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Does obesity influence early outcome of fixed-bearing unicompartmental knee arthroplasty?

Woo

Chen

Lai

et al. 2017

J Orthop Surg (Hong Kong)

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Obesity is a known major contributing risk factor for knee osteoarthritis (OA). It is also believed that obese unicompartmental knee arthroplasty (UKA) patients tend to have poorer outcome and possible early failure. The purpose of this study is to investigate the early outcome of obese UKA patients in a single institution. Patients who underwent fixed bearing medial UKA in between year 2005 and 2010 were included in this study. They were divided into four groups based on Body Mass Index (BMI): 25 kg/m 2 (Control); 25-29.9 kg/m 2 (Overweight); 30-34.9 kg/m 2 (Obese); >35 kg/m 2 (Severely Obese). Functional outcome was assessed using Knee Society Score (KSS), Oxford Knee Score (OKS) and Short-form 36 (SF-36). One-way ANOVA with Bonferroni post-hoc test was used to compare the four groups for quantitative variables. There were 673 patients in this study, no significant difference between the four BMI groups for gender and side of operated knee (p > 0.05). The functional outcome of all four groups at 2 years were comparable (all p > 0.05). At a mean follow up of 5.4 (range 2.5, 8.5) years, 9 revision surgeries (1.3%) were identified. The mean duration from initial surgery to revision surgery was 49 months (Range 6, 90). Patients' pre-operative BMI did not influence the early outcome of UKA patients. However, patients with higher BMI had relatively lower functional score prior to the surgery and tended to be younger. This did not translate to early failure and the functional improvement was similar among all four groups.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does obesity influence early outcome of fixed-bearing unicompartmental knee arthroplasty?

Woo

Chen

Lai

et al. 2017

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

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“…An in vitro robotic studies by Suggs showed that knee stability is not altered by a medial fixed bearing UKA but they conclude that ACL is essential to avoid greater anterior tibial translation [29]. Their findings on similar ACL forces in the native knee and following UKA led to the conclusion that ACL also plays a role in the latter condition.…”

Section: Resultsmentioning

confidence: 99%

Medial unicompartmental knee arthroplasty in the ACL-deficient knee

Mancuso

Dodd

Murray

et al. 2016

J Orthopaed Traumatol

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Symptomatic osteoarthritis (OA) of the knee develops often in association with anterior cruciate ligament (ACL) deficiency. Two distinct pathologies should be recognised while considering treatment options in patients with end-stage medial compartment OA and ACL deficiency. Patients with primary ACL deficiency (usually traumatic ACL rupture) can develop secondary OA (typically presenting with symptoms of instability and pain) and these patients are typically young and active. Patients with primary end stage medial compartment OA can develop secondary ACL deficiency (usually degenerate ACL rupture) and these patients tend to be older. Treatment options in either of these patient groups include arthroscopic debridement, reconstruction of the ACL, high tibial osteotomy (HTO) with or without ACL reconstruction, unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). General opinion is that a functionally intact ACL is a fundamental prerequisite to perform a UKA. This is because previous reports showed higher failure rates when ACL was deficient, probably secondary to wear and tibial loosening. Nevertheless in some cases of ACL deficiency with end-stage medial compartment OA, UKA has been performed in isolation and recent papers confirm good short- to mid-term outcome without increased risk of implant failure. Shorter hospital stay, fewer blood transfusions, faster recovery and significantly lower risk of developing major complications like death, myocardial infarction, stroke, deep vein thrombosis (as compared to TKA) make the UKA an attractive option, especially in the older patients. On the other hand, younger patients with higher functional demands are likely to benefit from a simultaneous or staged ACL reconstruction in addition to UKA to regain knee stability. These procedures tend to be technically demanding. The main aim of this review was to provide a synopsis of the existing literature and outline an evidence-based treatment algorithm.

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“…Whilst some authors have suggested that TKAs offer the patient a lower risk of early revision, advocates of UKAs have suggested that functional outcomes, particularly in patients who participate in high-demand activities, are superior in those who undergo UKA compared with TKA [29,[31][32][33]. This is based on the concept that the UKA, particularly the mobilebearing UKA, allows a greater replication of the native knee joint [34]. Whether the potential advantages, which the UKA may provide in kinematics, is demonstrated over a longer term would require further assessment.…”

Section: Discussionmentioning

confidence: 98%

The mid-term clinical results of the phase 3 Oxford unicompartmental knee arthroplasty: a 6- to 8-year follow-up

Smith

Clark

Glasgow

et al. 2011

Eur J Orthop Surg Traumatol

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Unicompartmental knee arthroplasty (UKA) is widely performed in the United Kingdom for the management of patients with symptomatic osteoarthritis of the medial compartment of the tibiofemoral joint. A limited number of papers have presented the findings of mid-term clinical and survival data with sufficiently large patient numbers following mobile-bearing UKA. The purpose of this study was to present the 6- to 8-year follow-up data on a series of 230 minimally invasive medial Oxford Phase 3 mobile-bearing UKAs in our institution. Data on surgical procedure, postoperative rehabilitation requirement, complications, revision procedures and Oxford Knee Score (OKS), Short Form-12 (SF-12) and visual analogue scale (VAS) pain scores were analysed. The results indicated that the majority of patient’s recoveries were uneventful, with 96% experiencing no postoperative complications. The mean OKS, VAS pain and SF-12 scores indicated good functional outcomes and acceptable perceived general health for this age group. Twenty-one patients underwent revision surgery, indicating a survival rate of 85% (95% CI: 0.76–0.91) during the 6- to 8-year follow-up period. The most frequently cited indication for revision was due to progression of osteoarthritis to the lateral component. To conclude, this series indicated that the mobile-bearing Oxford UKA provides good clinical outcomes at 6- to 8-year follow-up, with minimal requirement for postoperative rehabilitation, few complications and an acceptable survivorship in the mid-term

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Function of the anterior cruciate ligament after unicompartmental knee arthroplasty

Cited by 57 publications

References 25 publications

Does obesity influence early outcome of fixed-bearing unicompartmental knee arthroplasty?

Does obesity influence early outcome of fixed-bearing unicompartmental knee arthroplasty?

Medial unicompartmental knee arthroplasty in the ACL-deficient knee

The mid-term clinical results of the phase 3 Oxford unicompartmental knee arthroplasty: a 6- to 8-year follow-up

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