Abstract
PurposePosterior cruciate ligament (PCL) deficiency is considered to be a contraindication for unicompartmental knee replacement (UKR); however, there is no evidence to support or contradict this. There are occasional circumstances where UKR in PCL deficient patients have been performed where the patient otherwise satisfies the indications for UKR. The aim of this paper is to describe the outcome of UKR in PCL deficient patients.MethodsA retrospective study of patients with painful medial compartment osteoarthritis and PCL deficiency treated with Oxford UKR between 2006 and 2015 was undertaken. Clinical records from a prospectively recorded database were reviewed and outcomes were assessed based on revision rate, Oxford Knee Score (OKS), American Knee Society score and Tegner Activity Score.ResultsNine patients were identified. The median age at surgery was 51 years (range 42–80) and median follow-up was 6 years (range 1–10). There was one bearing dislocation requiring open exchange. The outcome of seven patients was excellent (OKS > 41). Two patients, who were both elderly, had good outcomes (OKS 41 and 39). One patient had a poor outcome, but it is not clear if this was related to the knee as she had a learning disability and examination and radiographs of the knee were satisfactory.ConclusionThe results of this small series suggest that excellent results can be achieved with UKR for selected patients with medial osteoarthritis in a PCL deficient knee that was functioning well before the osteoarthritis developed. On the basis of this a larger study should be undertaken. Until more results are available PCL deficiency should be considered a relative contra-indication to UKR.Level of evidenceIV.
Highlights
Unicompartmental knee replacement (UKR) is an effective treatment for knee osteoarthritis
The aim of this study was to review the functional and revision outcomes of the few patients with medial osteoarthritis and Posterior cruciate ligament (PCL) deficiency who have been treated with UKR
A retrospective case series is described of patients with medial osteoarthritis and PCL deficiency who were treated with Oxford UKR by four surgeons
Summary
Unicompartmental knee replacement (UKR) is an effective treatment for knee osteoarthritis. Compared to total knee replacement (TKR), UKR has a faster recovery, lower morbidity and mortality, better functional outcomes, and is more cost effective [1, 2, 9, 19]. One of the primary aims of UKR is to restore knee kinematics to normal. This is only possible if all the ligaments are functionally intact, even if they are not anatomically normal. The common situation in which there is knee osteoarthritis with functionally normal ligaments is anteromedial osteoarthritis [17]. The main indication for UKR is anteromedial osteoarthritis with bone-onbone medially, full thickness cartilage laterally and
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