Department of Orthopaedics and Traumatology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
J Knee Surg. 2022 Aug;35(10):1087-1090. doi: 10.1055/s-0040-1722322. Epub 2021 Feb 5.
Young and more active patients with medial compartmental osteoarthritis (OA) in conjunction with anterior cruciate ligament (ACL) deficiency are challenging for orthopaedic surgeons. The aim of the present study was to examine the early-mid clinical and radiological outcomes of combined Oxford unicondylar knee arthroplasty (UKA) and ACL reconstruction for the patients presenting ACL deficiency and concomitant medial compartment symptomatic OA. Twelve patients were included in the study. All patients were treated by combination of ACL reconstruction with medial UKA. The varus-valgus angles of the tibial and femoral components, and pathological radiolucent lines were measured on anteroposterior and lateral knee radiographs. Clinical evaluations include knee osteoarthritis outcome score (KOOS pain, symptom, daily life, sports, and quality of life), Oxford knee score (OKS), EQ-5D-3L, and EQ-visual analog scale (VAS). All the patients were followed up for an average of 45.6 months. The leg alignment showed 3.6 degrees ± 1 of varus deformity before surgery and 2.6 degrees ± 1 of valgus after surgery. With the exception of KOOS sports ( > 0.001), the KOOS pain, symptom, daily life, and quality of life, OKS, EQ-5D-3L, and EQ-VAS improved significantly after surgery ( < 0.001). Preoperative knee instability showed anterior translation of 5 to 10 mm in eight patients and >10 mm in four patients. There were no complications at follow-up. The early-mid clinical data have shown that UKA in conjunction with ACL reconstruction has revealed promising results. However, long-term follow-up studies are required to confirm the combined procedure in these patients.
年轻且更活跃的内侧间室骨关节炎(OA)合并前交叉韧带(ACL)缺失的患者对骨科医生来说是一个挑战。本研究旨在探讨同时患有 ACL 缺失和内侧间室症状性 OA 的患者接受 ACL 重建联合 Oxford 单髁膝关节置换术(UKA)的早期中期临床和影像学结果。研究纳入了 12 名患者。所有患者均采用 ACL 重建联合内侧 UKA 治疗。测量了胫骨和股骨组件的内翻-外翻角以及前后位和侧位膝关节 X 线片上的病理性透光线。临床评估包括膝关节骨关节炎结局评分(KOOS 疼痛、症状、日常生活、运动和生活质量)、Oxford 膝关节评分(OKS)、EQ-5D-3L 和 EQ-视觉模拟量表(VAS)。所有患者平均随访 45.6 个月。下肢对线在术前显示 3.6°±1 度的内翻畸形,术后为 2.6°±1 度的外翻畸形。除 KOOS 运动(>0.001)外,KOOS 疼痛、症状、日常生活和生活质量、OKS、EQ-5D-3L 和 EQ-VAS 在术后均显著改善(<0.001)。术前膝关节不稳定表现为 8 例患者前向平移 5 至 10mm,4 例患者>10mm。随访时无并发症。早期中期临床数据表明,UKA 联合 ACL 重建已显示出良好的效果。然而,需要进行长期随访研究来确认该联合方案在这些患者中的应用。