2025 ISAKOS Biennial Congress ePoster
Successful Outcomes in Combined Unicompartmental Knee Arthroplasty and Anterior Cruciate Ligament Reconstruction : A Clinical Study
Theodore Balfousias, MD, MSc, FEBOT, Thessaloniki GREECE
Ilias Fanourgiakis, MD, MSc, FEBOT, Melissia, Athens GREECE
Rainer Siebold, Prof. Dr. med., Heidelberg GERMANY
INTERNATIONAL CENTER FOR ORTHOPEDICS, ATOS CLINIC, HEIDELBERG, GERMANY
FDA Status Cleared
Summary
Purpose of the authors is to evaluate the clinical outcomes and patient satisfaction after Unicompartmental Knee Arthroplasty and ACL reconstruction in patients suffering from osteoarthritis isolated in a single compartment with simultaneous ACL deficiency.
ePosters will be available shortly before Congress
Abstract
Managing advanced osteoarthritis isolated to a single knee compartment, when accompanied by anterior cruciate ligament (ACL) deficiency, continues to be a subject of ongoing discussion among orthopedic surgeons.Twenty-two patients with ACL deficiency and concomitant medial or lateral knee OA were treated from 2011 to 2022 with a combined UKA (Journey Unilateral Knee System) and ACLR using tendon autograft (Semi-T, Quadriceps-, Patella-Tendon). The follow-up assessment included Lysholm score, Knee Injury and Osteoarthritis Outcome Score - KOOS (symptoms, pain, Sports, ADL: activities of daily living, QoL: quality of life, Total), International Knee Documentation Committee (IKDC 2000), Tegner activity scale and VAS score for pain and satisfaction. Revisions to total knee arthroplasty (TKA) were documented. Survivorship analysis was performed using the Kaplan–Meier method.
Average follow-up was 6 ± 3.1 years (1.2-11.5). The mean age was 57.9 ± 8.1 years (40-72) with 5 female and 17 male patients. Twenty-one medial, one lateral, and 18 single bundle, 4 double bundle procedures were performed. Fourteen of 22 procedures were carried out simultaneously. Staged procedures were performed with a maximum time interval of 12 months (1-12). All scores improved significantly, with exception of the Tegner activity score. Implant survivorship was 76.2% at 11.5 years. Three revisions with conversion to total knee arthroplasty were performed at 5, 5.2 and 6.8 years postoperatively. Reasons for revisions were loosening of the femoral component, posterior polyethylene wear and OA progression at the other condyle. In the remaining 19 knees there were no observations of radiological component loosening or clinical signs of ACL instability.
UKA combined with ACL reconstruction can be a valid treatment option with good clinical results for selected patients in short to midterm follow-up. It can restore knee stability and address the advanced single compartment arthritis. Experience is required though in both surgical techniques.