Outcome of combined unicompartmental knee replacement and combined or sequential anterior cruciate ligament reconstruction

A study of 52 cases with mean follow-up of five years

J. S. Weston-Simons, H. Pandit, C. Jenkins, W. F. M. Jackson, A. J. Price, H. S. Gill, C. A. F. Dodd, D. W. Murray

Abstract

The Oxford unicompartmental knee replacement (UKR) is an established treatment option in the management of symptomatic end-stage medial compartmental osteoarthritis (MCOA), which works well in the young and active patient. However, previous studies have shown that it is reliable only in the presence of a functionally intact anterior cruciate ligament (ACL). This review reports the outcomes, at a mean of five years and a maximum of ten years, of 52 consecutive patients with a mean age of 51 years (36 to 57) who underwent staged or simultaneous ACL reconstruction and Oxford UKR. At the last follow-up (with one patient lost to follow-up), the mean Oxford knee score was 41 (sd 6.3; 17 to 48). Two patients required conversion to TKR: one for progression of lateral compartment osteoarthritis and one for infection. Implant survival at five years was 93% (95% CI 83 to 100). All but one patient reported being satisfied with the procedure. The outcome was not significantly influenced by age, gender, femoral or tibial tunnel placement, or whether the procedure was undertaken at one- or two-stages.

In summary, ACL reconstruction and Oxford UKR gives good results in patients with end-stage MCOA secondary to ACL deficiency.

Footnotes

  • The authors wish to thank Mrs B. E. A. Marks and Mrs J. Brown for their assistance with this study. The study has been supported by the NIHR Biomedical Research Unit into Musculoskeletal Disease, Nuffield Orthopaedic Centre and the University of Oxford. Financial support has been received from Biomet.

    The author or one of more of the authors have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article. In addition, benefits have been or will be directed to a research fund, foundation, educational institution, or other non-profit organisation with which one or more of the authors are associated.

  • Supplementary material. A further opinion by J. Murray is available with the electronic version of this article on our website at www.boneandjoint.org.uk/site/education/further_op

  • Received December 8, 2011.
  • Accepted May 9, 2012.
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