The Functional Status Of The ACL In Varus OA Of The Knee: The Association With Varus Deformity And Coronal Tibiofemoral Subluxation

Objective:To analyze the relationship between lower limb deformity and coronary tibiofemoral subluxation(CTFS)on anterior cruciate ligament function in patients with varus knee osteoarthritis.Methods:A total of 117 patients with unicondylar joint replacement and total knee arthroplasty for varus knee osteoarthritis performed by the same clinician from September 2021 to October 2022 were retrospectively analyzed.According to the exclusion criteria,a total of 86 knee joints were included in this study.According to the anterior cruciate ligament function status,the patients were divided into two groups:functional sufficient(ACL+)and functional insufficient(ACL-)status.The degree of varus deformity and tibiofemoral coronal subluxation of knee joint were evaluated by full-length radiographs and anterior-lateral radiographs in weight-bearing position,and the difference between the two groups was compared.Results:There was statistical significance in preoperative CTFS between the ACL+ group and the ACL-group(5.2±1.5 VS 8.27±2.74,P=0.001).The HKA Angle was 8.46±3.03 VS 13.33±4.86.P=0.001),the difference was statistically significant.MPTAAngle(84.56±1.58 VS 84.17±1.46,P=0.374)had no significant difference.Preoperative and postoperative motion,HSS score and VAS score were significantly improved in both groups.Conclusion:Large varus deformity of knee joint and Coronary tibiofemoral subluxation suggest that anterior cruciate ligament may be insufficient.Both total knee joint and unicondylar replacement can effectively improve the degree of Coronary tibiofemoral subluxation in patients with varus deformity osteoarthritis,so that patients can obtain good postoperative results,and are reliable options for the treatment of advanced knee osteoarthritis.