Medial Unicompartmental Knee Arthroplasty Combined With Anterior Cruciate Ligament Reconstruction Yields Similar Outcomes Compared to Unicompartmental Knee Arthroplasty Alone

Background: The treatment of unicompartmental knee osteoarthritis (OA) in young, active individuals with anterior cruciate ligament (ACL) insufficiency is a debatable topic. The objective, radiological, and functional results of medial unicompartmental knee arthroplasty (UKA) combined to ACL reconstruction and those of isolated UKA are compared in the present study. Methods: Twelve patients with medial OA and ACL incompetence were suitable for combined UKA and ACL reconstruction (Group A). A control group consisted of 24 patients who underwent isolated UKA within the same time frame and were matched for age, body mass index, and male/female ratio (Group B). The Oxford Knee Score (OKS), the Knee OA Outcome Score (KOOS), the WOMAC index of OA, and standard X-rays were used for clinical and radiologic evaluation. Results: The mean KOOS score, OKS, and WOMAC index improved 10 years after surgery, demonstrating a statistically significant change (p < 0.001). At follow-up, there was no significant between-groups difference concerning KOOS, OKS, or WOMAC scores (p=n.s.). One female patient in Group A underwent revision total knee arthroplasty (TKA) 3 years after the first surgery because OA in the lateral compartment had developed and the patient's discomfort persisted. There were no signs of pathologic radiolucent lines or radiographic signs of implant loosening at the most recent follow-up, which occurred at an average of 7.9 years for Group A and 9.1 years for Group B. Conclusion: Ten years after surgery, UKA combined to ACL reconstruction provides clinical and radiographic results similar to UKA without increasing the incidence of complications.