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Updated: Jan 27, 2026

Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
Approximately 30% of Functioning Anterior Cruciate Ligaments Are Sacrificed for Knee Arthroplasty
Takafumi Hiranaka1, Yuichi Hida1, Takaaki Fujishiro1
1Department of Orthopaedic Surgery and Joint Surgery Centre, Aijinkai Takatsuki General Hospital, Takatsuki, Osaka, Japan.
Abstract:
The anterior cruciate ligament (ACL) plays an important role in knee kinematics. Unicompartmental knee arthroplasty (UKA) preserves the ACL, an advantage over total knee arthroplasty (TKA), where it is sacrificed. This study aims to evaluate how often functional ACLs are sacrificed in arthroplasty. The type of arthroplasty (TKA or UKA) and condition of the ACL were studied in a total of 1,586 knees in 1,052 patients who underwent knee arthroplasties. Of 1,586 knees, TKA was performed on 653 knees (41%) and UKA on 933 knees (59%). The ACL was functioning in 77% of all knees. Of the TKA knees, the ACL was functioning in 357 knees (55%). Of these, around 30% of the functioning ACLs were sacrificed to perform TKA. To improve postoperative patient satisfaction after knee arthroplasty, further study regarding relationship between ACL preservation and clinical outcome will be required.
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