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cal or chondral injury and the development of
osteoarthritis [11]. However, the effectiveness
of surgery in preventing degenerative changes
remains controversial [1, 2] as premature knee
osteoarthritis can still develop despite recons-
truction. With conservative treatment the risk
of knee osteoarthritis developing has been
reported as high as 44% after 11 years [14] and
that greater than 50 % have led to a TKA befo-
re the age 63 [13]. In cases where there is the
onset of osteoarthritis multiple treatments have
been suggested depending on the clinical and
radiological findings [18] such as; ACL
reconstruction associated with a high tibial
osteotomy (HTO) [3] or unicompartimentale
prosthesis [5] or meniscal allograft [15] and
isolated HTO [7]. In the situation of moderate
to severe osteoarthritis TKA is often the mana-
gement of choice depending on the symptoms.
Advanced osteoarthritis in ACL-deficient knee
has been well described by H. Dejour [4] in
1987. Radiologically the most frequent sign in
the antero-posterior view is a medial femoroti-
bial osteoarthritis which is associated with a
lateral tibial translation that increases propor-
tionately with time. The lateral view demons-
trates anterior tibial translation associated with
the characteristic dished form deficit of the
posteromedial tibia plateau (cupula) (fig. 2).
Our report is the first on TKAs performed for
osteoarthritis in chronic isolated ACL deficient
knees. The goal of this study was to evaluate
the outcomes of TKA after untreated ACL
injury and determine if previous ACL injury
impacted the quality of the result. Using a mat-
ched cohort, we found no statistically signifi-
cant differences in the outcomes studied bet-
ween those who had previous ACL injury and
those who did not before TKA. We also found
no difference in terms of postoperative clinical
scores, flexion, RLL or revision rates.
TOTAL KNEE ARTHROPLASTY: A SAFE AND EFFECTIVE PROCEDURE FOR ADVANCED OSTEOARTHRITIS…
311
Fig. 2 : Medial osteoarthritis associated with anterior tibial translation
and dished form deficit of the posteromedial tibia plateau