Evidence map›Paper›PMID 41246644›Full record

ReviewCureus2025

Comparative Outcomes of Synchronous Anterior Cruciate Ligament (ACL) Reconstruction With Medial Unicompartmental Knee Replacement (UKR) in ACL-Deficient Knees Versus Conventional UKR in ACL-Competent Knees: A Systematic Review and Meta-Analysis.

Khong W Lee, Aatif Mahmood, Ashwani Nugur, Siva S Santhanam, Khairina Khairuddin

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Khong W LeeTrauma and Orthopaedics, Ysbyty Gwynedd, Bangor, GBR.
Aatif MahmoodTrauma and Orthopaedics, Countess of Chester Hospital NHS Foundation Trust, Chester, GBR.
Ashwani NugurTrauma and Orthopaedics, Ysbyty Gwynedd, Bangor, GBR.
Siva S SanthanamOrthopaedics, Ysbyty Gwynedd, Bangor, GBR.
Khairina KhairuddinPublic Health, Birmingham City University, Birmingham, GBR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Medial unicompartmental knee replacement (UKR) is a joint-preserving alternative to total knee arthroplasty for patients with isolated medial compartment osteoarthritis. Historically, anterior cruciate ligament (ACL) deficiency has been considered a contraindication to UKR due to concerns over implant failure and instability. However, synchronous ACL reconstruction with UKR has emerged as a potential solution, aiming to restore joint stability while preserving native biomechanics. This review evaluates whether outcomes differ between synchronous ACL reconstruction with UKR and conventional UKR in ACL-intact knees. A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Sixteen studies were included, comprising 1842 knees, 312 in the intervention group, and 1530 in the comparator group. Eligible studies reported outcomes such as Oxford Knee Score (OKS), Knee Society Score (KSS), implant survival, revision rates, and complications. Meta-analysis was performed using a random-effects model to account for heterogeneity. Both groups demonstrated substantial improvements in patient-reported outcome measures (PROMs), with OKS, Knee injury and Osteoarthritis Outcome Score (KOOS), and KSS scores indicating high postoperative satisfaction. Implant survivorship ranged from 87.5% to 100% in the intervention group and 92-95% in the comparator group. A statistically significant mean OKS difference of 1.6 points favoured the intervention group (p=0.0251), though this fell below the minimal clinically important difference threshold, suggesting functional equivalence. Synchronous ACL reconstruction with UKR offers comparable outcomes to conventional UKR in ACL-intact knees. This approach may be particularly beneficial for younger, active patients with ACL deficiency. Further prospective studies are needed to validate long-term efficacy and refine patient selection.

Indexed as

anterior cruciate ligament reconstruction (aclr)combined acl reconstruction and ukaknee osteoarthritissurgical outcomesunicompartmental knee replacement

Identifiers

PMID41246644
PMCPMC12612607

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.