One stage unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction after a minimum follow-up of 10 years

Treatment for unicompartmental knee osteoarthritis is controversial in young patients with concomitant anterior cruciate ligament (ACL) deficiency. The aim of the current study is to report long-term results after the combination of unicompartmental knee arthroplasty (UKA) and ACL reconstruction. Retrospective study of one-stage medial UKA and ACL reconstruction performed on 8 patients at a mean age of 52 years (42 to 60). Clinical and radiological results were assessed and analyzed after a mean follow-up of 14.6 years. A control cohort of 8 patients with intact ACL, treated by UKA in isolation, was selected for a comparative study. Patients were very satisfied and mean personal satisfaction rate was 8.8 (4 to 10). At the last follow-up, mean WOMAC score was 26 (1 to 52) and mean global KSS was 154 (102 to 200). No statistically significant differences were found between groups. One revision surgery to total knee arthroplasty was performed 9 years after the combined procedure due to aseptic loosening. One more case of clinical deterioration was observed.<br>Satisfactory mid-term results are achieved with the combined UKA and ACL reconstruction, which represents a good alternative to preserve bone stock and functional level of the knee in young patients. However, clinical deterioration can be observed in the long-term follow-up.

针对合并前交叉韧带（anterior cruciate ligament, ACL）缺损的年轻患者，单间室膝骨关节炎的治疗方案尚存争议。本研究旨在报道单间室膝关节置换术（unicompartmental knee arthroplasty, UKA）联合前交叉韧带重建术后的长期随访结果。本研究为回顾性研究，纳入8例平均年龄52岁（42~60岁）的患者，均接受一期内侧单间室膝关节置换术联合前交叉韧带重建术。所有患者经平均14.6年的随访后，对其临床及影像学结果进行评估与分析。另选取8例ACL完整、仅接受单间室膝关节置换术治疗的患者作为对照队列，开展对比研究。本研究纳入患者总体满意度极高，平均个人满意率为8.8分（4~10分）。末次随访时，患者的平均西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分为26分（1~52分），平均膝关节学会评分（Knee Society Score, KSS）总分为154分（102~200分）。两组间未发现统计学差异。1例联合手术患者于术后9年因无菌性松动接受全膝关节置换翻修术；另有1例患者出现临床症状恶化。
单间室膝关节置换术联合前交叉韧带重建术可获得满意的中期疗效，为年轻患者保留骨量及膝关节功能提供了良好的可选方案。但在长期随访过程中，仍可能观察到临床症状恶化的情况。