ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026
Medial mobile-bearing unicompartmental knee arthroplasty following anterior cruciate ligament reconstruction is associated with an increased revision risk compared to controls.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Five-year patient-reported outcomes after fixed-bearing medial UKA with broad patient selection.Arthroplasty (London, England) · 2026Article
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6 authors.
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Abstract
purposePatients with prior anterior cruciate ligament reconstruction (ACLR) are at increased risk of early medial osteoarthritis. Medial mobile-bearing (MB) unicompartmental knee arthroplasty (UKA) offers a minimal-invasive and joint-preserving alternative to total knee arthroplasty (TKA), yet evidence in ACLR patients remains limited. This study compared survivorship, reoperation causes and functional outcomes of medial MB UKA in ACLR patients versus matched controls.
methodsThis retrospective 1:2 matched case-control study included 106 medial MB UKAs after ACLR (mean age 61 ± 9 years; body mass index [BMI]: 29 ± 5 kg/m
resultsCumulative 9-year reoperation-free survival was significantly lower (p = 0.026) in the ACLR group (81.2%; 95% confidence interval [CI]: 71.8-90.6) compared with matched controls (92.1%; 95% CI: 88.2-96.0). Cumulative 9-year implant revision-free survival was also significantly lower (p = 0.004) in the ACLR group (89.8%; 95% CI: 81.8-97.8) compared with matched controls (98.4%; 95% CI: 96.6-100.0). For conversion to TKA, survival rates were 92.7% (95% CI: 85.3-100.0) and 98.2% (95% CI: 96.2-100.0), respectively (p = 0.071). The risk for bearing dislocation was eightfold higher in the ACLR group compared with controls (3.8% vs. 0.5%; p = 0.046). The mean postoperative OKS in the ACLR group was 42.5 ± 6.2 and 42.3 ± 6.1 in controls; the UCLA Activity Score was 6.3 ± 1.2 and 6.1 ± 1.2, respectively.
conclusionDespite excellent functional outcomes, ACLR patients undergoing MB UKA face a significantly higher risk for reoperation and inferior implant survival compared with matched controls. The increased risk for additional surgery in patients with prior ACLR, particularly for bearing dislocation, should be acknowledged when indicating medial UKA, and the usage of fixed-bearing implants reduces this risk. LEVEL OF EVIDENCE: Level III.
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