Comparison of gait kinetics in total and unicondylar knee replacement surgery

Ann R Coll Surg Engl. 2018 Apr;100(4):267-274. doi: 10.1308/rcsann.2017.0226. Epub 2018 Feb 27.

Abstract

Introduction The aim of this study was to compare kinetical data from gait analysis of patients who have undergone total and uni-condylar knee replacement. Materials and methods Thirteen patients with unilateral total knee arthroplasty (TKA) and 13 unicondylar knee arthroplasty (UKA), were included, all performed by the same surgeon more than one year prior. The Vicon gait analysis system was used. Statistical power was calculated using SPSS. Results No significant difference was found in the spatiotemporal parameters of gait and survival years of the knee prosthesis between the two groups. The UKA group was found to have significantly larger moments than the TKA group in knee adduction on the operated side and knee flexion moment on the unoperated side during the loading phase. The maximum and minimum sagittal plane moments of the operated sides in the TKA group were significantly lower than the unoperated side. The difference was most significant at pre-swing. The maximum and minimum moments on the operated sides in the UKA group were significantly lower for the knee flexion and adduction moments when compared with the unoperated side and were most prevalent during the loading phase. Conclusions These results are relevant in terms of prosthesis wear. The TKA knees had smaller magnitude moments than the UKA knees in the sagittal and coronal planes. This could explain the higher revision rates for UKA. In both groups, the non-operated knees had significantly larger moments than the operated knees, which implies that after unilateral knee replacement of either type, the non-operated knee is being put under greater stress.

Keywords: Gait analysis; LCS mobile bearing; Oxford knee; Unilateral knee arthroplasty.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee / adverse effects
  • Arthroplasty, Replacement, Knee / instrumentation
  • Arthroplasty, Replacement, Knee / methods*
  • Biomechanical Phenomena
  • Body Mass Index
  • Female
  • Follow-Up Studies
  • Gait / physiology*
  • Humans
  • Kinesis / physiology
  • Knee Joint / physiology*
  • Knee Joint / surgery
  • Knee Prosthesis / adverse effects
  • Male
  • Osteoarthritis, Knee / surgery*
  • Prosthesis Failure
  • Range of Motion, Articular