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Abstract
Purpose
To compare the gait characteristics of unicompartmental knee arthroplasty (UKA) with total knee arthroplasty (TKA) performed on the same patient.
Materials and Methods
Twelve female patients with advanced degenerative arthritis of both knee joints were enrolled for the study group. The mean age was 70.3 (64-74) years old. One side of the knee joint had been replaced with UKA and the other side with TKA. The mean follow-up period was 11.8 months for the UKA side and 14.8 months for TKA side. The clinical and radiographic evaluations were performed. The gait features of the study group were assessed using computerized gait analysis. Seven age-matched healthy female volunteers (14 knees) were included as the normal control group.
Results
The clinical and radiographic results improved after joint replacement in both groups. The postoperative gait was almost normalized regardless of the type of surgery performed, with the exception of some parameters including the walking speed, mean pelvic tilt, knee flexion at initial contact, peak knee flexion, knee flexion between initial contact and loading response, knee flexion between initial swing phase and mid-stance phase and ankle 3rd rocker. Knee flexion at the initial contact of UKA and TKA groups was similar, and was different from that of the normal control group. At the loading response, the amount of knee flexion was similar between the three groups. Kinetic data of the first peak vertical ground reaction force and hip extension moment at loading response were better in the UKA group.
Figures and Tables
Fig. 1
Pelvic kinematics of the UKA and TKA groups. The pelvic motions of both groups showed a normal sinusoidal pattern.
Fig. 2
Kinematic and kinetic results of the hip joint in the sagittal plane. The hip motion in the sagittal plane (A) were normalized in both UKA and TKA groups. The amount of extensor moment (B) and power generation (C) at the loading response were still less than those in the normal control group.
Fig. 3
Knee joint kinematics of the UKA and TKA group. The knee joints of the UKA and TKA groups were not fully extended at the initial contact compared with the normal control group, but rather flexed about 14° (A). Knee joint alignment in the coronal plane was corrected in the TKA group (B). The knee joint of the UKA group still shows slight varus alignment (B). Tibial external torsion was well corrected in the TKA side than in the UKA side (C).
Fig. 4
Kinematic and kinetic results of the ankle joint in the sagittal plane. The first and second rockers were quite similar in the three groups, but the third rockers of the UKA and TKA group were less than the normal control group (A). The ankle push off moment (B) and power generation (C) of TKA group were ≤UKA group.
Fig. 5
Ground Reaction Force (GRF) of the UKA and TKA groups. The vertical GRF (A) showed two peaks during the loading response and push-off period. The first peak of the vertical GRF was almost normalized in the UKA side. The second peak of the vertical GRF was similar in both groups.
Table 2
Gait Parameters for Analysis and Results of Each Group
Parameter 1-4 for the linear parameters, 5-7 for the hip and pelvis, 8-17 for the knee, 18-20 for the ankle and 21-22 for the ground reaction force. *, statistical significance between the TKA group and UKA group. †, statistical significance between the TKA group and control group. ‡, statistical significance between the UKA group and control group. §, statistical significance between both groups and the control group. Max, maximum; min, minimum; IC, initial contact; LR, loading response; MST, midstance; ISW, initial swing; HEM, hip extensor moment; KEM, knee extensor moment; KVM, Knee varus moment; v-GRF, vertical ground reaction force.
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