J Knee Surg 2020; 33(07): 655-658
DOI: 10.1055/s-0039-1683928
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Approximately 30% of Functioning Anterior Cruciate Ligaments Are Sacrificed for Knee Arthroplasty

Takafumi Hiranaka
1   Department of Orthopaedic Surgery and Joint Surgery Centre, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan
,
Yuichi Hida
1   Department of Orthopaedic Surgery and Joint Surgery Centre, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan
,
Takaaki Fujishiro
1   Department of Orthopaedic Surgery and Joint Surgery Centre, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan
,
Tomoyuki Kamenaga
1   Department of Orthopaedic Surgery and Joint Surgery Centre, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan
,
Kenichi Kikuchi
1   Department of Orthopaedic Surgery and Joint Surgery Centre, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan
,
Ryo Yoshikawa
1   Department of Orthopaedic Surgery and Joint Surgery Centre, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan
,
Shotaro Tachibana
1   Department of Orthopaedic Surgery and Joint Surgery Centre, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan
,
Koji Okamoto
1   Department of Orthopaedic Surgery and Joint Surgery Centre, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan
› Author Affiliations
Further Information

Publication History

17 March 2018

05 February 2019

Publication Date:
25 March 2019 (online)

Abstract

The anterior cruciate ligament (ACL) plays an important role in knee kinematics. Unicompartmental knee arthroplasty (UKA) preserves the ACL, an advantage over total knee arthroplasty (TKA), where it is sacrificed. This study aims to evaluate how often functional ACLs are sacrificed in arthroplasty. The type of arthroplasty (TKA or UKA) and condition of the ACL were studied in a total of 1,586 knees in 1,052 patients who underwent knee arthroplasties. Of 1,586 knees, TKA was performed on 653 knees (41%) and UKA on 933 knees (59%). The ACL was functioning in 77% of all knees. Of the TKA knees, the ACL was functioning in 357 knees (55%). Of these, around 30% of the functioning ACLs were sacrificed to perform TKA. To improve postoperative patient satisfaction after knee arthroplasty, further study regarding relationship between ACL preservation and clinical outcome will be required.

 
  • References

  • 1 Argenson JN, Komistek RD, Aubaniac JM. , et al. In vivo determination of knee kinematics for subjects implanted with a unicompartmental arthroplasty. J Arthroplasty 2002; 17 (08) 1049-1054
  • 2 Chassin EP, Mikosz RP, Andriacchi TP, Rosenberg AG. Functional analysis of cemented medial unicompartmental knee arthroplasty. J Arthroplasty 1996; 11 (05) 553-559
  • 3 Siman H, Kamath AF, Carrillo N, Harmsen WS, Pagnano MW, Sierra RJ. Unicompartmental knee arthroplasty vs total knee arthroplasty for medial compartment arthritis in patients older than 75 years: comparable reoperation, revision, and complication rates. J Arthroplasty 2017; 32 (06) 1792-1797
  • 4 Lum ZC, Lombardi AV, Hurst JM, Morris MJ, Adams JB, Berend KR. Early outcomes of twin-peg mobile-bearing unicompartmental knee arthroplasty compared with primary total knee arthroplasty. Bone Joint J 2016; 98-B (10) , Supple B ): 28-33
  • 5 Kim MS, Koh IJ, Choi YJ, Lee JY, In Y. Differences in patient-reported outcomes between unicompartmental and total knee arthroplasties: a propensity score-matched analysis. J Arthroplasty 2017; 32 (05) 1453-1459
  • 6 White SH, Ludkowski PF, Goodfellow JW. Anteromedial osteoarthritis of the knee. J Bone Joint Surg Br 1991; 73 (04) 582-586
  • 7 Halewood C, Traynor A, Bellemans J, Victor J, Amis AA. anteroposterior laxity after bicruciate-retaining total knee arthroplasty is closer to the native knee than ACL-resecting TKA: a biomechanical cadaver study. J Arthroplasty 2015; 30 (12) 2315-2319
  • 8 Borque KA, Gold JE, Incavo SJ, Patel RM, Ismaily SE, Noble PC. Anteroposterior knee stability during stair descent. J Arthroplasty 2015; 30 (06) 1068-1072
  • 9 Jacobs CA, Christensen CP, Karthikeyan T. An intact anterior cruciate ligament at the time of posterior cruciate ligament-retaining total knee arthroplasty was associated with reduced patient satisfaction and inferior pain and stair function. J Arthroplasty 2016; 31 (08) 1732-1735
  • 10 Murray DW, Goodfellow JW, O'Connor JJ. The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br 1998; 80 (06) 983-989
  • 11 Gibson PH, Goodfellow JW. Stress radiography in degenerative arthritis of the knee. J Bone Joint Surg Br 1986; 68 (04) 608-609
  • 12 Rosenberg TD, Paulos LE, Parker RD, Coward DB, Scott SM. The forty-five-degree posteroanterior flexion weight-bearing radiograph of the knee. J Bone Joint Surg Am 1988; 70 (10) 1479-1483
  • 13 Goodfellow JW, Kershaw CJ, Benson MK, O'Connor JJ. The Oxford Knee for unicompartmental osteoarthritis. The first 103 cases. J Bone Joint Surg Br 1988; 70 (05) 692-701
  • 14 Hamilton TW, Choudhary R, Jenkins C. , et al. Lateral osteophytes do not represent a contraindication to medial unicompartmental knee arthroplasty: a 15-year follow-up. Knee Surg Sports Traumatol Arthrosc 2017; 25 (03) 652-659
  • 15 Pandit H, Jenkins C, Gill HS. , et al. Unnecessary contraindications for mobile-bearing unicompartmental knee replacement. J Bone Joint Surg Br 2011; 93 (05) 622-628
  • 16 Beard DJ, Pandit H, Ostlere S, Jenkins C, Dodd CA, Murray DW. Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome. J Bone Joint Surg Br 2007; 89 (12) 1602-1607
  • 17 Goodfellow J, O'Conner J, Dodd C. , et al. Unicompartmental Arthroplasty with the Oxford Knee. Oxford: Goodfellow Publishers; 2006: 35
  • 18 Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?. Clin Orthop Relat Res 2010; 468 (01) 57-63
  • 19 Matsuda S, Kawahara S, Okazaki K, Tashiro Y, Iwamoto Y. Postoperative alignment and ROM affect patient satisfaction after TKA. Clin Orthop Relat Res 2013; 471 (01) 127-133
  • 20 Nam D, Barrack T, Nunley RM, Barrack RL. What is the frequency of noise generation in modern knee arthroplasty and is it associated with residual symptoms?. Clin Orthop Relat Res 2017; 475 (01) 83-90
  • 21 Khatib Y, Madan A, Naylor JM, Harris IA. Do psychological factors predict poor outcome in patients undergoing TKA? A systematic review. Clin Orthop Relat Res 2015; 473 (08) 2630-2638
  • 22 Nakahara H, Okazaki K, Mizu-Uchi H. , et al. Correlations between patient satisfaction and ability to perform daily activities after total knee arthroplasty: why aren't patients satisfied?. J Orthop Sci 2015; 20 (01) 87-92
  • 23 Wylde V, Blom AW, Whitehouse SL, Taylor AH, Pattison GT, Bannister GC. Patient-reported outcomes after total hip and knee arthroplasty: comparison of midterm results. J Arthroplasty 2009; 24 (02) 210-216
  • 24 Bourne RB, Chesworth B, Davis A, Mahomed N, Charron K. Comparing patient outcomes after THA and TKA: is there a difference?. Clin Orthop Relat Res 2010; 468 (02) 542-546
  • 25 Hamilton TW, Pandit HG, Lombardi AV. , et al. Radiological decision aid to determine suitability for medial unicompartmental knee arthroplasty: development and preliminary validation. Bone Joint J 2016; 98-B (10) , Supple B ): 3-10
  • 26 Liddle AD, Pandit H, Judge A, Murray DW. Optimal usage of unicompartmental knee arthroplasty: a study of 41,986 cases from the National Joint Registry for England and Wales. Bone Joint J 2015; 97-B (11) 1506-1511
  • 27 Boissonneault A, Pandit H, Pegg E. , et al. No difference in survivorship after unicompartmental knee arthroplasty with or without an intact anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 2013; 21 (11) 2480-2486
  • 28 Engh GA, Ammeen DJ. Unicondylar arthroplasty in knees with deficient anterior cruciate ligaments. Clin Orthop Relat Res 2014; 472 (01) 73-77
  • 29 Sabatini L, Giachino M, Risitano S, Atzori F. Bicompartmental knee arthroplasty. Ann Transl Med 2016; 4 (01) 5
  • 30 Pritchett JW. Bicruciate-retaining total knee replacement provides satisfactory function and implant survivorship at 23 years. Clin Orthop Relat Res 2015; 473 (07) 2327-2333