Medial unicompartmental knee arthroplasty in the ACL-deficient knee View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-09

AUTHORS

Francesco Mancuso, Christopher A. Dodd, David W. Murray, Hemant Pandit

ABSTRACT

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. More... »

PAGES

267-275

References to SciGraph publications

  • 2009-06. Predicting anterior cruciate ligament integrity in patients with osteoarthritis in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2012-01. Combined unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2013-11. No difference in survivorship after unicompartmental knee arthroplasty with or without an intact anterior cruciate ligament in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2016-01. Clinical outcome after UKA and HTO in ACL deficiency: a systematic review in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2011-12. Closing-wedge high tibial osteotomy: survival and risk factor analysis at long-term follow up in BMC MUSCULOSKELETAL DISORDERS
  • 2009-12. ACL reconstruction with unicondylar replacement in knee with functional instability and osteoarthritis in JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
  • 2017-03. Medial unicondylar knee arthroplasty combined to anterior cruciate ligament reconstruction in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2006-05. The effect of closed wedge high tibial osteotomy on tibial slope: a radiographic study in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2011-10. Anterior cruciate ligament reconstruction after unicompartmental knee arthroplasty in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2009-08. Osteotomien am Kniegelenk bei Monokompartmentarthrose in DER ORTHOPÄDE
  • 2014-01. Unicondylar Arthroplasty in Knees With Deficient Anterior Cruciate Ligaments in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s10195-016-0402-2

    DOI

    http://dx.doi.org/10.1007/s10195-016-0402-2

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27160183


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