Anterior cruciate ligament reconstruction in association with medial unicompartmental knee replacement: a retrospective study comparing clinical and radiological outcomes of two different implant design

AbstractPurposeUnicompartmental knee arthroplasty (UKA) combined with anterior cruciate ligament (ACL) reconstruction has recently been suggested as a feasible treatment option for young and active patients with medial compartment osteoarthritis (OA) and ACL deficiency. The aim of this study is to evaluate retrospectively the outcomes of two different implant designs in patients with medial OA secondary to traumatic ACL rupture, who underwent combined ACL reconstruction and unicompartmental knee replacement.MethodsFrom January 2007, to December 2013, 24 patients with medial OA secondary to ACL rupture underwent medial unicompartmental knee arthroplasty (UKA) and ACL reconstruction. Nine patients received a mobile bearing UKA (Group 1) and fifteen a fixed-bearing one (Group 2). The mean follow-up was 53  ± 8.3 months for Group 1 and 42 ± 6.7 months for Group 2. Knee Society Score (KSS), Western Ontario and McMaster Index of Osteoarthritis (WOMAC) index and radiological evaluation used to assess the implant loosening alignment of the knee joint and tibial slope were recorded pre-operativ ely and at the last follow-up.ResultsAt the final follow-up, all patients showed statistically significant clinical improvements with respect to the pre-operative values (p 
Source: International Orthopaedics - Category: Orthopaedics Source Type: research

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Int J Sports Med DOI: 10.1055/a-0902-8539The purpose of this study was to conduct an up-to-date systematic review and meta-analysis of radiographic knee osteoarthritis (OA) over minimal ten years after ACL reconstruction. The database of Pubmed and the Ovid was adopted. The radiographic knee OA over minimal ten years after ACL reconstruction was systematically reviewed. Both the ipsilateral and contralateral knees were evaluated referring to the tibiofemoral joint (TFJ), the patellofemoral joint (PFJ), and the overall knee OA prevalence. Nineteen studies were included for review, with nine screened for the meta-analysis. T...
Source: International Journal of Sports Medicine - Category: Sports Medicine Authors: Tags: Review Source Type: research
ConclusionAnatomic ACL angle was restored after reconstruction with both the TT and AM techniques, despite different FGAs. No significant differences in clinical outcome were noted between groups on physical exam or KOOS at 2  years after surgery. These results suggest that TT reconstruction results in a graft position similar to that seen in AM reconstruction and that the location of the intra-articular tunnel aperture matters more than the orientation of the tunnel.
Source: HSS Journal - Category: Orthopaedics Source Type: research
Finite element models with patient-specific geometries and motions and relatively simple material models of tissues were able to identify areas susceptible to post-traumatic knee osteoarthritis. We suggest that the methodology presented here may be applied in large cohort studies.
Source: Clinical Biomechanics - Category: Orthopaedics Authors: Source Type: research
ConclusionsLarge variations of PFJ OA after ACL injury are associated with different follow-up period and surgical techniques. ACL reconstructed population with bone-patellar tendon-bone graft, single-bundle reconstruction, and delayed operation time has a high prevalence of PFJ OA.
Source: Journal of Orthopaedic Translation - Category: Orthopaedics Source Type: research
Publication date: Available online 13 July 2019Source: Journal of Arthroscopy and Joint SurgeryAuthor(s): Raju Vaishya, Maduka Celestine Okwuchukwu, Amit Kumar Agarwal, Vipul VijayAbstractAnterior Cruciate Ligament (ACL) injuries are common in the knee and are often caused by sports injuries. These injuries are common among the young population of the society and are significant causes of morbidity and functional impairment. Arthroscopic ACL Reconstruction (ACLR) is considered as a gold standard in the management of ACL injuries. ACLR has been shown to restore the joint stability, and improve the functional outcome. Nevert...
Source: Journal of Arthroscopy and Joint Surgery - Category: Orthopaedics Source Type: research
AbstractPurposeThe purpose of this study was to report the long-term outcomes of a continuous series of patients who underwent simultaneous anterior cruciate ligament (ACL) reconstruction and opening wedge high tibial osteotomy (HTO) for varus-related early medial tibio-femoral osteoarthritis. It was hypothesized that this combined surgery sustainably allowed return to sport with efficient clinical and radiological results.MethodsFrom 1995 to 2015, all combined ACL reconstruction (bone-patellar tendon-bone graft) and opening wedge HTO for anterior laxity and early medial arthritis were included. Clinical evaluation at fina...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
People who have had anterior cruciate ligament reconstruction (ACLR) are at a high risk of developing tibiofemoral joint (TFJ) osteoarthritis (OA), with concomitant meniscal injury elevating this risk. This st...
Source: BMC Musculoskeletal Disorders - Category: Orthopaedics Authors: Tags: Research article Source Type: research
J Knee Surg DOI: 10.1055/s-0039-1692647A study was conducted to retrospectively evaluate the outcomes of combined medial unicompartmental knee replacement (UKR) and anterior cruciate ligament (ACL) reconstruction. The hypothesis was that this procedure would lead to satisfying results in patients affected by medial osteoarthritis and ACL insufficiency. Fourteen patients with ACL deficiency and concomitant medial compartment symptomatic osteoarthritis were treated from 2006 to 2010. Twelve of them were followed-up for an average time of 7.8 year (range: 6–10 years). Assessment included Knee Osteoarthritis Outco...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
ConclusionThis systematic review found that the use of HTO for ACLR revision produces good post-operative functional outcomes, low complication rates, and no reported re-ruptures. The main indications for combined HTO with ACLR revision was a posterior slope of more than 12 ° or severe varus malalignment. Future studies with large sample sizes and long-term follow-up are required to corroborate these results.
Source: HSS Journal - Category: Orthopaedics Source Type: research
Objective: To evaluate the mechanism of injury, outcomes, and complications of anterior cruciate ligament (ACL) reconstruction in overweight and obese patients. Data Sources: MEDLINE, EMBASE, and OVID electronic libraries were systematically searched from inception to December, 2017 for any eligible articles using a combination of the phrases “anterior cruciate ligament,” “ACL,” “overweight,” “obese,” and “BMI.” Results: Studies that evaluated patients with primary ACL reconstruction, classified patients as overweight or obese, and reported a minimum of 1-...
Source: Clinical Journal of Sport Medicine - Category: Sports Medicine Tags: General Review Source Type: research
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