Comparison of gait and balance in total and unicompartmental knee arthroplasties

doi:10.3877/cma.j.issn.1674-134X.2020.01.003

Abstract

Abstract:

Objective

To investigategait kinetics and balance after unicompartmental knee arthroplasty(UKA) and total knee arthroplasty(TKA).

Methods

A retrospective study of 70 patients with knee replacement in the First Affiliated Hospital of Anhui Medical University and the Fourth Affiliated Hospital of Anhui Medical University from January 2016 to December 2017 was carried out, and they were divided into UKA group and TKA group according to the different operation methods. Thirty five healthy elderly people without history of hip and knee pain or dysfunction were recruited as the control group. Inclusion criteria: medial compartmental knee osteoarthritis with intact cruciate ligament and lateral collateral ligaments, no serious disease of the lower limbs on the non operative side. Exclusion criteria: neurological diseases and other serious lower extremity diseases, bilateral knee replacement at the same time, body mass index (BMI)>30 kg/m².In the UKA group, there were 14 males and 21 females, with an average age of (63.4±7.0)years. The TKA group included 13 males and 22 females with an average age of (65.0±6.1)years old. In the control group, there were 16 males and 19 females with an average age of (64.6±7.1) years. All the cases were completed by the same surgeon. The gait and postural balance parameters were recorded, including gait speed, step length, cadence, single-limb support phase(SLS), center of pressure (COP) path length, 90 %COP postural sway area. One-way ANOVA and Tukey test was applied in age, BMI, gait kinematics parameters and postural balance parameters. Chi-square test were used for gender comparison of three groups. t test was used for HSS score comparison of UKA group and TKA group.

Results

The average follow-up period was (23±15)months. No prosthetic loosening, dislocation, lesions of contralateral compartment joint developed. SLS, COP path length and 90 %COP postural sway area of UKA group were better than those of TKA group (P<0.05). There were significant differences in terms of COP path length and 90 %COP postural sway area between the UKA group and the control group (P<0.05).

Conclusion

This study shows gait kinetics and balance after UKA may be superior to THA, but the balance is still inferior to the normal elderly.

Key words: Arthroplasty, replacement, knee, Gait, Postural balance

Penghui Ke, Zongsheng Yin, Ming Lu, Kai Lin, Wei Lu, Ce Dai. Comparison of gait and balance in total and unicompartmental knee arthroplasties[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(01): 11-16.

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References 31

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组别	例数	年龄(岁)	性别(男/女)	BMI(kg / m²)	术前HSS评分(分)
UKA组	35	63.4±7.0	14 / 21	23.8±2.8	46.3±5.8
TKA组	35	65.0±6.1	13 / 22	24.3±3.1	45.2±5.2
对照组	35	64.6±7.1	16 / 19	22.6±3.2	NA
统计值		F＝0.532 9	χ²＝0.551 4	F＝2.89 5	t＝0.835 4
P值		>0.05	>0.05	>0.05	>0.05

组别	例数	年龄(岁)	性别(男/女)	BMI(kg / m²)	术前HSS评分(分)
UKA组	35	63.4±7.0	14 / 21	23.8±2.8	46.3±5.8
TKA组	35	65.0±6.1	13 / 22	24.3±3.1	45.2±5.2
对照组	35	64.6±7.1	16 / 19	22.6±3.2	NA
统计值		F＝0.532 9	χ²＝0.551 4	F＝2.89 5	t＝0.835 4
P值		>0.05	>0.05	>0.05	>0.05

组别	例数	术后HSS评分(分)	步速(m / s)	步频(步/ min)	步长(m)	单足支撑相(%)
UKA组	35	85.10±4.90	1.04±0.08	103.50±6.80	0.59±0.06	39.80±2.50^a
TKA组	35	81.30±5.20^a	1.02±0.06	102.80±8.70	0.58±0.05	38.20±2.80^ab
对照组	35	NA	1.07±0.11	105.40±9.70	0.61±0.06	40.10±3.00
统计值		t＝3.146	F＝3.009	F＝0.8798	F＝2.526	F＝4.744
P值		<0.05	>0.05	>0.05	>0.05	<0.05

组别	例数	术后HSS评分(分)	步速(m / s)	步频(步/ min)	步长(m)	单足支撑相(%)
UKA组	35	85.10±4.90	1.04±0.08	103.50±6.80	0.59±0.06	39.80±2.50^a
TKA组	35	81.30±5.20^a	1.02±0.06	102.80±8.70	0.58±0.05	38.20±2.80^ab
对照组	35	NA	1.07±0.11	105.40±9.70	0.61±0.06	40.10±3.00
统计值		t＝3.146	F＝3.009	F＝0.8798	F＝2.526	F＝4.744
P值		<0.05	>0.05	>0.05	>0.05	<0.05

组别	例数	COP路径长度(mm)	90%COP包络面积(mm²)
UKA组	35	584±224^ab	493±197^ab
TKA组	35	752±291^ab	875±296^ab
对照组	35	458±108	368±117
F值		15.59	52.28
P值		<0.01	<0.01

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