Function of the anterior cruciate ligament after unicompartmental knee arthroplasty: an in vitro robotic study

The objective of this study was to investigate the role of the anterior cruciate ligament (ACL) in the anterior-posterior (AP) stability of the knee after unicompartmental knee arthroplasty (UKA). AP tibial loads were applied to human cadaveric knee specimens using a robotic testing system. After UKA, the knee exhibited tibial translations similar to that of the native knee, and the forces in the ACL were also similar to those seen in the native knee. The ACL-deficient knee after UKA exhibited significantly greater anterior tibial translations than the native knee and the knee after UKA with an intact ACL. These data suggest that medial UKA does not alter the anterior stability of the knee, but a functional ACL is necessary to ensure normal stability after UKA.