Unicompartmental arthroplasty of the knee: Cadaver study of the importance of the anterior cruciate ligament

Abstract

The tibiofemoral articulation on horizontal and 10 degrees tilted tibial components was examined radiographically in 20 cadaver knees after lateral arthroplasty, and after cutting the anterior cruciate ligament in 10 knees with medial and 10 with lateral arthroplasty. Articulation took place more posteriorly on the horizontal components at any degree of flexion examined; a correlation was found between the operation-induced change in the inclination of the lateral tibial plateau and the point of articulation. Based on the regression equations, the expected point of articulation on an arbitrarily chosen component placement could be calculated for any degree of flexion provided the preoperative inclination was known. Cutting the anterior cruciate ligament caused articulation to move posteriorly on the tibial component at both medial and lateral arthroplasty. We concluded that it was possible to estimate the tilt of the tibial component that was required to avoid marginal articulations when the preoperative slope of the tibial plateau was known. Absence of the anterior cruciate ligament seems to contraindicate unicompartmental arthroplasty.