Influence of anterior cruciate ligament defect on the mid-term outcome of fixed-bearing unicompartmental knee arthroplasty / 中国组织工程研究

ABSTRACT

BACKGROUND: Fixed-bearing unicompartmental knee arthroplasty has become an effective method for the treatment of medial single-compartment osteoarthritis of the knee joint. In recent years, with the continuous development of the design of unicompartmental prosthesis and surgical techniques, age, body mass idex and patellofemoral joint lesions are no longer the absolute contraindication for fixed-bearing unicompartmental knee arthroplasty. However, it is still controversial whether anterior cruciate ligament defects affect the survival rate of fixed-bearing unicompartmental knee arthroplasty. OBJECTIVE: To investigate the clinical effect and revision rate of unicompartmental knee arthroplasty in the patients with medial univentricular osteoarthritis and anterior cruciate ligament deficiency. METHODS: A total of 268 patients with single-compartment osteoarthritis of the medial knee joint admitted to Foshan Hospital of Traditional Chinese Medicine from March 2014 to March 2016 were selected, including 111 males and 157 females, who were all treated with fixed-bearing unicompartmental knee arthroplasty. According to preoperative MRI and intraoperative exploration, the patients were divided into anterior cruciate ligament defect group (n=45) and anterior cruciate ligament intact group (n=223). After 4-6 years of follow-up, the survival rate of the prosthesis was counted. The knee function was evaluated by hospital for special surgery knee score and Tegner scores. Hip knee ankle angle and posterior slope angle were analyzed to evaluate the lower limb alignmentthe. Six degrees of freedom kinematic parameters of the knee joint were obtained by the three-dimensional dynamic evaluation system guided by infrared light to evaluate objectively knee joint function after operation. The study was approved by Ethics Committee of Foshan Hospital of Traditional Chinese Medicine (approval No. 20140317). RESULTS AND CONCLUSION: (1) Complications such as postoperative persistent pain and progressive arthritis of lateral compartment occurred in both groups. The rate of revision was 4.40% in anterior cruciate ligament defect group and 4.03% in anterior cruciate ligament intact group. There was no significant difference between the two groups (P > 0.05). (2) At the last follow-up, there was no significant difference in hospital for special surgery knee score, Tegner score, hip knee ankle angle and posterior slope angle between the two groups (P > 0.05). (3) At the last follow-up, the data of six degrees of freedom were similar between the two groups, including knee varus angle, flexion and extension angle, internal and external rotation angle, up and down displacement, internal and external displacement, anteroposterior displacement movement (P > 0.05). (4) The results showed that during the follow-up period, unicompartmental knee arthroplasty has the same surgical effect and prosthesis survival rate in anterior cruciate ligament defect patients with stable knee joint as that of patients with intact anterior cruciate ligament.