POSTER ABSTRACTS - ISAKOS

E-poster #508
ACL Reconstruction and Oxford UKA: A Viable
Treatment Option for ACL Deficient Arthritic
Knees
Hemant Pandit, Oxford, UNITED KINGDOM,
Presenter
David Beard, Oxford, UNITED KINGDOM
Cathy Jenkins, Oxford, UNITED KINGDOM
Neil Thomas, Hants, UNITED KINGDOM
David Murray, Oxford, UNITED KINGDOM
Christopher Dodd, Oxford, UNITED KINGDOM
OOEC, Nuffield Orthopaedic Centre, Oxford,
UNITED KINGDOM
Introduction: Unicompartmental knee arthroplasty
(UKA) is an increasingly popular procedure for
young osteoarthritic patients whose age and
activity levels preclude the use of a total knee
arthroplasty. However, successful reconstruction
using an unconstrained mobile bearing implant
requires an intact and functioning ACL. Patients
with isolated medial compartment OA and an
absent ACL therefore provide a management
dilemma for the treating surgeon. One option is to
perform a combined ACL reconstruction and
mobile bearing UKA. This paper presents early
results of this new procedure using an Oxford UKA
and ACL reconstruction using an autograft.
Materials and Methods: Eleven patients who
underwent one or two-staged ACL reconstruction
and Oxford UKA for treatment of symptomatic
medial compartment OA were reviewed at two
years after surgery. The combined procedure
required specific precautions and considerations;
care had to be taken to place the tibial tunnel as
far laterally as possible to avoid impingement of
the graft by the tibial implant. In 8 cases,
hamstring graft was used and the procedure was
staged. In three cases, bone-patella-tendon-bone
graft was used for ACL reconstruction and both
the procedures were performed under the same
anaesthetic.
Results: All patients were male with an average
age of 49 years (range: 36 - 52) and mean follow
up of 3.1 (2-4.1) years. One patient needed
revision to TKA due to infection. The objective and
functional knee society scores improved pre to
post operatively from 55 to 98, and 85 to 100,
respectively.
Conclusions: ACL reconstruction and
simultaneous or staged UKA is a viable treatment
option for patients with symptomatic medial
compartment arthritis in whom the ACL is absent.
Early results of this technically demanding
procedure are encouraging but longer follow-up is
required.
E-poster #509
Predictors of Decreased Function and Activity
Level in Patients Seeking Treatment for
Osteoarthritis of the Knee
Karen K Briggs, Vail, CO, USA, Presenter
J. Richard Steadman, Vail, CO USA
Steadman Hawkins Sports Medicine Foundation,
Vail, CO, USA
Introduction: One of three adults in the United
States is affected by arthritis or chronic joint
symptoms and arthritis is currently the leading
cause of disability in the United States. As the
population ages, these numbers will increase.
Increased prevalence of arthritis is also associated
with decreased activity. Identifying factors
associated with decreased function and decreased
activity may help develop early treatment
programs which can decrease the impact of
arthritis. The purpose of this study was to identify
determinants of decreased function, as
determined by Lysholm score, and patient activity
level, as determined by Tegner Activity Level, in
patients Presenter for evaluation of osteoarthritis
of the knee.
Methods: A cohort of patients (n=242, average
age = 56 (range 29 to 82); 101 females, 141 males),
who were diagnosed with OA of the knee on initial
exam, was studied prospectively. All patients had
complete demographic, subjective and objective
data from the initial exam. Patient symptoms
were graded on a 4-point scale (none, mild,
moderate, severe). The dependent variables were
Lysholm score (0-100) and Tegner Activity level(1-
10). Univariate and multivariable analysis were
performed to identify determinants.
Results: Prior surgeries were reported in 58% of
the knees, and 80% had joint space narrowing on
radiographic examination. For demographic
variables, there were no significant differences
(p>0.05) in Lysholm for age, gender, or prior
surgery. Tegner was significantly associated
(P