Outcomes of Combined Unicompartmental Knee Replacement and Anterior cruciate ligament Reconstruction: A Systematic Review

Abstract

ACL deficiency can be primary or secondary. Primary ACL deficiency typically occurs due to significant trauma, this mainly lead to development of secondary OA of the knee and following nonsurgical management of ACL rupture. Secondary ACL deficiency occurs in the setting of established knee OA and is typically insidious in nature. Patients with a primary ACL deficiency are typically younger, and more active, with a more focal disease pattern wear mainly antromedial, whereas in secondary ACL deficiency, patients are typically older and less active with a more extensive pattern of disease wear mostly posterior. Modified Ahlbäck classification classifies knee OA to five grades. In Grade 1, 2 and 3 ACL is intact, Grade 4 is associated with rupture of the ACL. In Grade 5, there is anterior subluxation of the tibia. First reports highlighted a higher incidence of complications, in terms of tibial loosening and higher revision rate, when UKA were performed in ACL-deficient knees. While they defined ACL deficiency as an exclusion criterion for UKA, recent literature suggests that ACL deficiency without instability may not be a strict contraindication to partial-knee replacement.