ACL-deficient knee and unicompartmental OA: state of the art

Adravanti, Paolo; Budhiparama, Nicolaas C.; Berend, Keith R.; Thienpont, Emmanuel

doi:10.1136/jisakos-2016-000066

Cited by 9 publications

(7 citation statements)

References 70 publications

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“…Several differences were found between our personal surgical technique and that proposed by other surgeons. The first difference concerns the femoral tunnel: while some surgeons prefer to create the tunnel during arthrotomy to minimise the risk of infection, we prefer to create it arthroscopically through the anteromedial portal because this allow for a more accurate anatomical orientation [17]. Although we performed all the tunnels arthroscopically, no infections were observed in our patients.…”

Section: Discussionmentioning

confidence: 99%

“…The use of different prosthesis designs (fixed-or mobile-bearing) did not affect clinical and radiological outcomes at middle-term follow-up. Original study 4 (mobile-bearing) [34][35][36][37] 4 (fixed-bearing) [13,[31][32][33] Systematic review 3 [16,18,29] State-of-the-art 1 [17]…”

Section: Discussionmentioning

confidence: 99%

“…Unicompartmental knee arthroplasty (UKA) combined with ACL reconstruction has been recently suggested as a feasible treatment option for young and active patients with medial compartment OA and ACL deficiency [17,18]; however, a limited experience exists in this field.…”

Section: Introductionmentioning

confidence: 99%

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Anterior cruciate ligament reconstruction in association with medial unicompartmental knee replacement: a retrospective study comparing clinical and radiological outcomes of two different implant design

Tecame

Savica

Rosa

et al. 2019

International Orthopaedics (SICOT)

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Purpose Unicompartmental knee arthroplasty (UKA) combined with anterior cruciate ligament (ACL) reconstruction has recently been suggested as a feasible treatment option for young and active patients with medial compartment osteoarthritis (OA) and ACL deficiency. The aim of this study is to evaluate retrospectively the outcomes of two different implant designs in patients with medial OA secondary to traumatic ACL rupture, who underwent combined ACL reconstruction and unicompartmental knee replacement. Methods From January 2007, to December 2013, 24 patients with medial OA secondary to ACL rupture underwent medial unicompartmental knee arthroplasty (UKA) and ACL reconstruction. Nine patients received a mobile bearing UKA (Group 1) and fifteen a fixed-bearing one (Group 2). The mean follow-up was 53 ± 8.3 months for Group 1 and 42 ± 6.7 months for Group 2. Knee Society Score (KSS), Western Ontario and McMaster Index of Osteoarthritis (WOMAC) index and radiological evaluation used to assess the implant loosening alignment of the knee joint and tibial slope were recorded pre-operatively and at the last follow-up. Results At the final follow-up, all patients showed statistically significant clinical improvements with respect to the pre-operative values (p < 0.05). No significant difference was observed in WOMAC index and KSS both objective and functional between groups at the last follow-up (KSS obj. 73.4 ± 9.3 vs 77.3 ± 10.5; KSS funct. 86.2 ± 6.2 vs 84.7 ± 5.9; WOMAC 79.3 ± 7.3 vs 81.3 ± 7.6 for Group 1 and 2, respectively). No differences in radiolucent lines were found between the groups. Conclusion The use of different prosthesis design (fixed-or mobile-bearing) during a combined procedure of ACL reconstruction and medial unicompartmental arthroplasty does not affect the middle-term clinical and radiological outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Anterior cruciate ligament reconstruction in association with medial unicompartmental knee replacement: a retrospective study comparing clinical and radiological outcomes of two different implant design

Tecame

Savica

Rosa

et al. 2019

International Orthopaedics (SICOT)

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“…Adravanti et al 3 suggested that patients with medial OA and ACL tear who have instability tend to perform poorly when only UKR is performed in them. The options for treatment in our case were either to perform, a revision to a total knee arthroplasty (TKA) or an ACLR as there was no relief in symptoms after conservative management.…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic ACL Tear With Oxford Mobile Bearing UKA In Situ: Management Tips and Pearls

Kumar

Panthee

Yadav

et al. 2020

Techniques in Orthopaedics

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A 59-year-old female individual with bilateral unicompartmental knee arthroplasty (UKA) in situ suffered post-traumatic left anterior cruciate ligament (ACL) tear. She was managed with an arthroscopic ACL reconstruction with an autologous hamstring graft. The outside-in technique was used with a suspensory method of fixation. Currently, the patient has completed 2 years of follow-up with an improvement of the functional scores to the preinjury levels. Given the paramount importance of the integrity of ACL to a well-functioning UKA, the present case shows a suitable treatment option for patients with ACL injury post-UKA and highlights the surgical technique.

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“…When instability is the main symptom, ACL reconstruction without addressing the OA is indicated. In their state-of-the-art article on ACL deficient knee and unicompartmental OA,1 the authors advise us to ‘listen to our patients’ if we are really to serve them. ‘Treat the patient, and not the X-ray or MRI’; ‘Limit yourself to what’s really needed’.…”

mentioning

confidence: 99%

Minimalism and the art of medicine

Dijk¹

2017

Journal of ISAKOS

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ACL-deficient knee and unicompartmental OA: state of the art

Cited by 9 publications

References 70 publications

Anterior cruciate ligament reconstruction in association with medial unicompartmental knee replacement: a retrospective study comparing clinical and radiological outcomes of two different implant design

Anterior cruciate ligament reconstruction in association with medial unicompartmental knee replacement: a retrospective study comparing clinical and radiological outcomes of two different implant design

Post-traumatic ACL Tear With Oxford Mobile Bearing UKA In Situ: Management Tips and Pearls

Minimalism and the art of medicine

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