Abstract
Background
Anterior cruciate ligament (ACL) deficiency is commonly considered a contraindication
for unicompartmental knee arthroplasty (UKA). The purpose of this study is to compare
the outcomes of UKA after prior ACL reconstruction (rACL cohort) to UKA with an intact
native ACL (nACL cohort).
Methods
Forty-five patients from 3 institutions who underwent medial UKA after prior rACL
were matched by age, gender, preoperative function scores, and body mass index to
90 patients who underwent UKA with an intact nACL. Primary outcomes were Knee Injury
and Osteoarthritis Outcome Score for Joint Replacement, Oxford Knee Scores, Knee Society
Functional Scores, and Kellgren-Lawrence scores in the unresurfaced, lateral tibiofemoral
compartment. Secondary outcomes were postoperative complications and the need for
revision to TKA.
Results
At a mean of 3.6 years, all PROMs improved significantly with no differences identified
between groups. The incidence of revision TKA was similar between cohorts (P = 1.00); however, the mean time to revision for progressive osteoarthritis was 4.0
years in the nACL group and 2.2 years in the rACL group. Twenty percent of rACL patients
had a postoperative complication compared to 8% in the nACL group. Despite presenting
with a similar degree of lateral arthritis, a greater percentage of patients developed
Kellgren-Lawrence scores of ≥3 in the rACL cohort (9%) than in the nACL cohort (0%).
Conclusion
A previously reconstructed ACL does not appear to compromise the short-term functional
outcomes of UKA; however, there is a higher rate of minor complications and progression
of lateral compartment arthritis, which should be considered with patients in the
shared decision process.
Keywords
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Article info
Publication history
Published online: October 23, 2021
Accepted:
October 17,
2021
Received in revised form:
October 7,
2021
Received:
July 21,
2021
Footnotes
No author associated with this paper has disclosed any potential or pertinent conflicts which may be perceived to have impending conflict with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2021.10.008.
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