Acceptable outcomes with unicompartmental knee replacement and PCL deficiency are achievable: a case series of nine patients

<p><strong>Purpose</strong></p> Posterior 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 de...

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Main Authors: Li, P, Kennedy, J, Mohammad, H, Pang, Z, Mellon, S, Jackson, W, Price, A, Dodd, C, Murray, D
Format: Journal article
Language:English
Published: Springer 2020
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author Li, P
Kennedy, J
Mohammad, H
Pang, Z
Mellon, S
Jackson, W
Price, A
Dodd, C
Murray, D
author_facet Li, P
Kennedy, J
Mohammad, H
Pang, Z
Mellon, S
Jackson, W
Price, A
Dodd, C
Murray, D
author_sort Li, P
collection OXFORD
description <p><strong>Purpose</strong></p> Posterior 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.</p> <p><strong>Methods</strong></p> <p>A 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.</p> <p><strong>Results</strong></p> <p>Nine 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.</p> <p><strong>Conclusion</strong></p> <p>The 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.</p> <p><strong>Level of evidence</strong></p> <p>IV.</p>
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spelling oxford-uuid:67b3680b-71aa-4acd-b64e-61d38eea7eb82022-03-26T18:40:06ZAcceptable outcomes with unicompartmental knee replacement and PCL deficiency are achievable: a case series of nine patientsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:67b3680b-71aa-4acd-b64e-61d38eea7eb8EnglishSymplectic ElementsSpringer2020Li, PKennedy, JMohammad, HPang, ZMellon, SJackson, WPrice, ADodd, CMurray, D<p><strong>Purpose</strong></p> Posterior 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.</p> <p><strong>Methods</strong></p> <p>A 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.</p> <p><strong>Results</strong></p> <p>Nine 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.</p> <p><strong>Conclusion</strong></p> <p>The 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.</p> <p><strong>Level of evidence</strong></p> <p>IV.</p>
spellingShingle Li, P
Kennedy, J
Mohammad, H
Pang, Z
Mellon, S
Jackson, W
Price, A
Dodd, C
Murray, D
Acceptable outcomes with unicompartmental knee replacement and PCL deficiency are achievable: a case series of nine patients
title Acceptable outcomes with unicompartmental knee replacement and PCL deficiency are achievable: a case series of nine patients
title_full Acceptable outcomes with unicompartmental knee replacement and PCL deficiency are achievable: a case series of nine patients
title_fullStr Acceptable outcomes with unicompartmental knee replacement and PCL deficiency are achievable: a case series of nine patients
title_full_unstemmed Acceptable outcomes with unicompartmental knee replacement and PCL deficiency are achievable: a case series of nine patients
title_short Acceptable outcomes with unicompartmental knee replacement and PCL deficiency are achievable: a case series of nine patients
title_sort acceptable outcomes with unicompartmental knee replacement and pcl deficiency are achievable a case series of nine patients
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