The Risk of ACL Avulsion Fracture with Bi-unicondylar Knee Arthroplasty

Description

In this detailed presentation, Jennifer Stoddart discusses her research on Bi-Unicondylar Knee Arthroplasty (Bi-UKA) and the risks of Anterior Cruciate Ligament (ACL) avulsion fractures associated with the procedure. She acknowledges her funder, Zimmer, and her co-authors, emphasizing the importance of their contributions to her findings. Stoddart explains that osteoarthritis can affect various components of the knee, with a meta-analysis revealing that a significant portion of patients suffer from bicompartmental knee osteoarthritis, which could benefit from combined partial knee arthroplasty.



The presentation elaborates on the findings related to gait and mechanical efficiency following Bi-UKA compared to Total Knee Arthroplasty (TKA), while also addressing the risk of intraoperative ACL avulsion fractures noted in prior studies. To further investigate this risk, the study employs finite element modeling to analyze the potential for ACL injuries during Bi-UKA, using validated models to predict fracture risks based on maximum principal elastic strain observed in the tibia. The analysis involves various scenarios, including the impact of surgical errors, implant positioning, and excessive bearing size.



Throughout the talk, Stoddart notes the importance of technique and patient-specific factors, including sex differences in bone strain responses, which indicate that Bi-UKA may pose higher risks for female patients. The findings suggest conservative approaches to selecting trial bearings to avoid loading associated with larger implant sizes, reinforcing the criticality of precise surgical practices, particularly regarding the medial implant's positioning. The presentation ends with acknowledgment for the opportunity to share this research, which prompts an engaged dialogue with the audience, highlighting ongoing inquiries about driving better outcomes in knee arthroplasty surgeries.

DOI: 10.1302/3114-221110

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