[The importance of ligament reconstruction with existing osteoarthritis]

Regarding the importance of ligament replacement in existing osteoarthritis three topics are highlighted: the development of osteoarthritis after ACL-tear or -replacement, ACL-replacement in existing osteoarthritis and ACL-replacement together with medial unicompartmental knee replacement. Concomitant lesions at the meniscus and cartilage, especially the patella-femoral cartilage are risk factors for the development and progression of osteoarthritis in ACL insufficiency. The treatment of a symptomatic ACL-insufficiency in existing osteoarthritis in the elderly patient is directly dependent on pre-existing degenerative changes. Medial unicompartmental knee replacement and ACL-replacement can, however, be well combined and lead to very good long-term results even in the young patient.