Skip to main content
Log in

No difference in survivorship after unicompartmental knee arthroplasty with or without an intact anterior cruciate ligament

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Anterior cruciate ligament deficiency (ACLD) has been considered a contraindication for Oxford unicompartmental knee arthroplasty (UKA) because of the reported higher incidence of failure when implanted in ACLD knees. However, given the potential advantages of UKA over total knee arthroplasty (TKA), we have performed UKA in a limited number of patients with ACL deficiency and end-stage medial compartment osteoarthritis (OA) over the past 11 years. The primary aim of this study was to establish the clinical outcome of this cohort; the secondary aim was to compare both clinical and radiographic data with a matched cohort of ACL-intact (ACLI) patients who have undergone UKA for anteromedial OA.

Methods

This retrospective observational study describes the clinical and radiological outcome in 46 medial Oxford UKAs implanted in 42 consecutive patients with ACL deficiency and concomitant symptomatic medial compartment OA at mean follow-up of 5 years. It also compares the outcomes with a matched cohort of UKA patients with an intact ACL (ACLI group).

Results

At the time of last follow-up, there was no significant difference in clinical results or survivorship between the two groups in this study.

Conclusion

The successful short-term results of the ACLD group suggest ACL deficiency may not always be a contraindication to Oxford UKA as previously thought. Until long-term data is available, however, we maintain our recommendation that ACLD be considered a contraindication.

Level of evidence

III.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Cardillo G (2008) KMPLOT: Kaplan-Meier estimation of the survival function http://www.mathworks.com/matlabcentral/fileexchange/22293

  2. Cartier P, Sanouiller JL, Greslamer RP (1996) Unicompartmental knee arthroplasty surgery. 10-year minimum follow-up period. J Arthroplasty 11:782–788

    Article  PubMed  CAS  Google Scholar 

  3. Christensen NO (1991) Unicompartmental prosthesis for gonarthrosis. A nine-year series of 575 knees from a Swedish hospital. Clin Orthop Relat Res 273:165–169

    PubMed  Google Scholar 

  4. Dawson J, Fitzpatrick R, Murray DW, Carr AJ (1998) Questionnaire on the perceptions of patients about total knee arthroplasty. J Bone Joint Surg [Br] 80-B:63–69

    Article  Google Scholar 

  5. Deschamps G, Lapeyre B (1987) Rupture of the anterior cruciate ligament: a frequently unrecognized cause of failure of unicompartmental knee prostheses. Apropos of a series of 79 Lotus prostheses with a follow-up of more than 5 years. Rev Chir Orthop Reparatrice Appar Mot 73:544–551

    PubMed  CAS  Google Scholar 

  6. Engh GA, Ammeen D (2004) Is an intact anterior cruciate ligmament needed in order to have a well-functioning unicondylar knee arthroplasty? Clin Orthop Relat Res 428:170–173

    Article  PubMed  Google Scholar 

  7. Goodfellow JW, Kershaw CJ, D’A Benson MK, O’Connor JJ (1988) The Oxford knee for unicompartmental osteoarthritis: the first 103 cases. J Bone Joint Surg [Br] 70-B:692–701

    Google Scholar 

  8. Harmen MK, Markovich GD, Banks SA, Hodge WA (1998) Wear patterns on tibial plateaus from varus and valgus osteoarthritic knees. Clin Orthop Relat Res 352:149–158

    Google Scholar 

  9. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14

    PubMed  Google Scholar 

  10. Jacobsen K (1981) Gonylaxometry. Stress radiographic measurement of passive stability in the knee joints of normal subjects and patients with ligament injuries: accuracy and range of application. Acta Orthop Scand [Suppl] 52(194):1–263

    Google Scholar 

  11. Kendrick BJ, Rout R, Bottomley NJ, Pandit H, Gill HS, Price AJ, Dodd CAF, Murray DW (2010) The implications of damage to the lateral femoral condyle on medial unicompartmental knee arthroplasty. J Bone Joint Surg [Br] 92-B:374–379

    Google Scholar 

  12. Keyes GW, Carr AJ, Miller RK, Goodfellow JW (1992) The radiographic classification of medial gonarthrosis. Acta Orthop Scand 63(5):497–501

    Article  PubMed  CAS  Google Scholar 

  13. Lee G, Cushner FD, Vigoritta V, Scuderi GR, Insall JN, Scott NS (2005) Evaluation of the anterior cruciate ligament integrity and degenerative arthritic patterns in patients undergoing total knee arthroplasty. J Arthroplasty 20:59–65

    Article  PubMed  Google Scholar 

  14. Mullaji AB, Marawar SV, Luthra M (2008) Tibial articular cartilage wear in varus osteoarthritic knees: correlation with anterior cruciate ligament integrity and severity of deformity. J Arthroplasty 23:128–135

    Article  PubMed  Google Scholar 

  15. Murray DW (2000) Unicompartmental knee arthroplasty: now or never? Orthopedics 23(9):979–980

    PubMed  CAS  Google Scholar 

  16. Pandit H, Beard J, Jenkins C, Kimstra Y, Thomas NP, Dodd CAF, Murray DW (2006) Combined anterior cruciate reconstruction and Oxford unicompartmental knee arthoplasty. J Bone Joint Surg [Br] 88-B:887–892

    Google Scholar 

  17. Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49

    PubMed  Google Scholar 

  18. Tibrewal SB, Grant KA, Goodfellow JW (1984) The radiolucent line beneath the tibial components of the Oxford meniscal knee. J Bone Joint Surg [Br] 66-B:523–528

    Google Scholar 

  19. White SH, Ludkowski PF, Goodfellow JW (1991) Anteromedial osteoarthritis of the knee. J Bone Joint Surg [Br] 73-B:582–586

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hemant Pandit.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Boissonneault, A., Pandit, H., Pegg, E. et al. No difference in survivorship after unicompartmental knee arthroplasty with or without an intact anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 21, 2480–2486 (2013). https://doi.org/10.1007/s00167-012-2101-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-012-2101-8

Keywords

Navigation