Long-term deterioration after one stage unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction

Treatment for unicompartmental knee osteoarthritis (OA)
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.

Patients were 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). 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 13 years after index surgery.

Combined
UKA and ACL reconstruction can be a therapeutic option for young and active
patients with concomitant knee instability and unicompartmental OA. The
procedure is highly demanding and reliable only in hands of experienced
surgeons. Over all, satisfactory outcome can be achieved at a minimum follow-up
of 10 years. However, clinical deterioration can be
observed in the long-term.