Total knee arthroplasty for advanced osteoarthritis in the anterior cruciate ligament deficient knee

Purpose Little is known about intra-operative difficulties and outcomes of TKA in ACL deficient knees. Methods Fifty-seven osteoarthritic knees (mean age 70 years) with a history of ACL injury underwent posterior-stabilised TKA. Intra-operative findings and results were compared with a matched control group. Results Difficult tibial exposure and bone loss were noted in the ACL-deficient group leading to one partial patellar tendon avulsion and one femoral condylar fracture. After three years, no infections or revisions occurred. No differences were noted in ROM, IKS knee score (95 +/- 6 versus 93 +/- 8, p=0.1), IKS function score (83 +/- 19 versus 84 +/- 16, p=0.7), or radiolucent line presence. Conclusions Total knee arthroplasty in ACL deficient knees is effective. Difficulty obtaining tibial exposure and posteromedial tibial bone defects should be anticipated. Outcomes are comparable to standard primary TKA.