Comparison of gait kinematics in total and unicondylar knee replacement surgery

Abstract

Introduction This study is aimed to compare kinematic gait data of patients who have undergone total and unicondylar knee replacement. Materials and methods This single-surgeon retrospective cohort study evaluated 13 patients with unilateral total knee arthroplasty (TKA) and 14 unicondylar knee arthroplasty (UKA). Gait analysis was carried out using a Vicon motion analysis system. The limits of knee flexion during stance phase, at heel strike and at loading response were measured. Results The total range of motion of the UKA knees was significantly greater than the TKA knees. UKA knees exhibited significantly greater knee extension during the stance phase than the TKA knees. Unlike TKA, UKA knees demonstrated improved knee flexion during the gait cycle when compared to the contralateral non-operated knee. The hips also demonstrated near normal hip flexion in UKA patients. Predictably, UKA knees had significantly greater varus compared with TKA in the coronal plane. Spatiotemporal variables demonstrated similar walking speed and step length to aid a fair comparison between knee replacement groups. Conclusions The UKA knees moved more physiologically in the sagittal plane with a greater range of motion during gait. Despite having a stiff gait pattern, the patients undergoing TKA demonstrated a more neutral alignment in the coronal plane. Neither type of knee arthroplasty restored knee kinematics to those of the non-operated side.

Preoperative Factors to Assess Risk for Postoperative Urinary Retention in Total Joint Arthroplasty: A Retrospective Analysis

“…Despite this wide variability, which is diagnostic criteria dependent, POUR is a significant concern for patients and health-care providers. Not only is an overdistended bladder and subsequent catheterization uncomfortable for the patient, but it may also increase the risk of urinary tract infections (UTIs) and delay mobilization [ 11 , 12 ], both of which may impede same-day discharge, leading to increased health-care costs. In the postoperative orthopedic setting, UTIs may undergo hematogenous seeding [ 13 ], which can lead to periprosthetic joint infections.…”

The extensor efficiency of unicompartmental, bicompartmental, and total knee arthroplasty

“…2 Patients with increased extensor strength report better outcomes, 40 however TKA is known to reduce extensor strength relative to native knees, 41 , 42 impacting gait and other functional activities. PKA has been associated with restoration of kinematics and gait toward that of the native knee, 17 improved range of motion, and faster return to desired physical function. 5 The improved function of PKA is, in part, a consequence of retention of the anterior cruciate ligament (ACL), which is otherwise sacrificed for nearly all TKA designs.…”

“…For patients with functional cruciate ligaments, and disease isolated to one tibiofemoral knee compartment, the use of unicompartmental knee arthroplasty (UKA) instead of TKA can lead to improved patient satisfaction and knee function, with reported benefits including faster gait, greater range of motion, and earlier return to desired activity. 7 , 17 - 21 There is also renewed interest in combined partial knee arthroplasty (CPKA) 22 , 23 where combinations of two or more partial knee arthroplasty (PKA) implants are used in the same knee. 24 Recent data have suggested that two-thirds of TKA patients could be candidates for PKA or CPKA.…”

Comparison of Biomechanical Gait Parameters and Patient-Reported Outcome in Patients After Total Knee Arthroplasty With the Use of Fixed-Bearing Medial Pivot and Multi-radius Design Implants—Retrospective Matched-Cohort Study

“…Thanks to such design, it was believed that patients will have not only better functional results but also better gait pattern and lower risk of polyethylene wear. However, in several studies [ [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] ] no superiority of this design was observed in comparison to the PS one in terms of patients’ satisfaction or improvement in range of motion. Only one study [ 21 ] reported a significantly better outcome of MP design in terms of Forgotten Joint Score.…”

“…Even though there are many studies concerning gait pattern after TKA [ [25] , [26] , [27] ], it is estimated that only one-third of patients show a biphasic pattern of sagittal plane moments which is considered physiological [ 28 ]. However, to our best knowledge, there is no study analyzing gait parameters of the knee after TKA with the use of MP knee design, and there are only two randomized-controlled trials, where authors compared gait patterns between two designs of TKA implants [ 29 , 30 ].…”