Description
Background: For the management of unicompartmental knee osteoarthritis (OA) in young, active patients with anterior cruciate ligament (ACL) insufficiency, unicompartmental knee arthroplasty (UKA) in combination with ACL reconstruction has been. Satisfactory mid-term results of this surgical procedure has been reported, although this is technically demanding procedure which may carry drawbacks such as impingement with the neoligament and improper sizing of the prosthetic tibia, and the relatively high rate of complications reported in some studies may limit this surgical option to become mainstream, in favour of traditional treatment options such as total knee arthroplasty (TKA).
Objectives: This study compares the subjective, radiological, and functional results of combined medial UKR with ACL reconstruction Vs. TKA. The hypothesis was that the combined treatment may offer comparable or superior outcomes without adding postoperative complications.
Methods: Twelve patients who underwent combined UKA and ACL reconstruction (Group A) were compared to 26 patients who received TKA in the same time frame (Group B) for age, male/female ratio, and body mass index. Oxford Knee Score (OKS), WOMAC index of osteoarthritis, Knee Osteoarthritis Outcome Score (KOOS), and routine X-rays were used for assessment.
Results: The mean overall KOOS score, OKS, WOMAC index increased from preoperatively, showing a statistically significant difference (p<.001). In terms of KOOS, OKS, or WOMAC scores at the most recent follow-up, there was no discernible difference between the groups (p=n.s.).
Three years following surgery, one female patient in group A received revision TKA due to the lateral compartment's osteoarthritis developing and the patient's pain persisting. Overall, at the most recent follow-up, there were no radiographic indications of implant loosening or proof of pathologic radiolucent lines.
Conclusions: UKA combined with ACL restoration offers clinical and radiographic outcomes comparable to TKA up to 10 years following surgery with no elevated risk of complications.
