Difference in knee rotation between total and unicompartmental knee arthroplasties during stair climbing

Jung, Myung‐Chul; Chung, Jae Youn; Son, Kwang-Hyun; Wang, Hui; Hwang, Jaejin; Kim, Jay Joong; Kim, Joon Ho; Min, Byoung‐Hyun

doi:10.1007/s00167-014-3064-8

Cited by 17 publications

(13 citation statements)

References 31 publications

(46 reference statements)

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“…Furthermore, in most cases unnatural kneeling activities or simple level walking have been analyzed. In a study by Jung et al [ 52 ] similar to the current study’s transverse plane knee kinematics were reported in a TKA- and UKA-group during stair climbing, whereby the UKA-group was supposed to present knee motion closer to normal than the TKA-group. A healthy CG or the investigation of the non-op limb was not included.…”

Section: Discussionsupporting

confidence: 80%

Compromised knee internal rotation in total knee arthroplasty patients during stair climbing

et al. 2018

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Due to the significant role of rotational properties for normal knee function, this study aimed to investigate transverse plane kinematics and kinetics in total knee arthroplasty and unicondylar knee arthroplasty patients during activities of daily living compared to a healthy control group, including stair ascent and descent. The study participants consisted of a total knee arthroplasty group including posterior cruciate retaining and posterior stabilized designs as well as a unicondylar knee arthroplasty group and a healthy control group. Three-dimensional kinematics and kinetics were captured using a Vicon system and two Kistler force plates embedded in the floor and another two in a staircase. Inverse dynamics of the lower limbs was computed in Anybody™ Modeling System. Transverse plane joint angles and joint moments were analyzed utilizing the statistical non-parametric mapping approach, considering the entire curve shape for statistical analysis. The patients with total knee arthroplasty exhibited significantly reduced knee internal rotation of the operated knee compared to the control group and the patients’ unimpaired limb, especially during the stair climbing tasks. Both unicondylar and total knee arthroplasty patients were found to have similar reduced internal rotation motion time series in stair descent. In conclusion, potential kinematic and kinetic benefits of unicondylar knee arthroplasty over total knee arthroplasty could not be proven in the current study. Aside from the usually mentioned reasons inducing constrained knee internal rotation in total knee arthroplasty patients, future studies should investigate to what extent co-contraction may contribute to this functional impairment in patients after knee arthroplasty surgery.

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Section: Discussionsupporting

confidence: 80%

Compromised knee internal rotation in total knee arthroplasty patients during stair climbing

et al. 2018

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“…investigated the difference during stair walking in patients with simultaneous TKA and UKA, and concluded that UKA knee might allow greater degree of rotation freedom, which resembled normal knee kinematics during stair walking. 22 In particular, UKA knees exhibited significantly greater degree of rotation in transverse planes, compared to TKA. However, in their study, peak tibial internal rotation moment in terminal stance phase was not evaluated.…”

Section: Discussionmentioning

confidence: 96%

A comparison of gait characteristics between posterior stabilized total knee and fixed bearing unicompartmental knee arthroplasties

Nishizawa

Harato

Morishige

et al. 2020

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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Background/Objective According to previous studies, physiological gait pattern was found in unicompartmental knee arthroplasty (UKA) as compared to total knee arthroplasty (TKA) concerning the gait parameters including gait speed, cadence, and step length. However, little attention had been paid to the detailed kinematic and kinetic differences during gait between TKAs and UKAs. The aim of the present study was to investigate and to clarify the biomechanical differences between posterior stabilized TKAs and fixed bearing UKAs during walking Methods A total of 28 patients participated in the present study. Fifteen patients who underwent TKA and thirteen patients who underwent UKA were enrolled. Gait analysis was done at an average of 12.9 months after surgery. The subjects performed level walking at a preferred speed. For each subject, three-dimensional kinematic, kinetic and ground reaction force data were recorded as well as clinical data including range of motion at the knee joint and plain radiographs. Differences of knee kinematics or kinetics were compared between TKAs and UKAs using two-tailed Mann Whitney U-test. Results On physical examination, passive range motion was significantly smaller in TKAs than in UKAs, while femorotibial angle on plain radiographs was not significantly different on plain radiographs. In terms of kinematics, TKAs were more flexed at heel contact and less extended in mid-stance phase compared to UKAs in the sagittal plane, and total excursion of TKAs were also smaller than UKAs. Regarding knee kinetics, TKA patients had significantly less peak tibial internal rotation moment in terminal stance phase. In addition, peak knee adduction moment was significantly larger in UKAs than in TKAs, while peak knee flexion moment was not significantly different. Conclusion Posterior stabilized TKAs exhibited less peak tibial internal rotation moment, which is known as pivot shift avoidance gait, in the present study, compared to fixed bearing UKAs. TKAs had similar gait pattern to anterior cruciate ligament deficient knees, compared to UKAs even if patients with TKAs had no subjective pain during walking.

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“…Further potential reasons for normal knee kinematics and kinetics in UKA patients, such as the preservation of the lateral knee compartment or different bearing shapes compared with TKA, should be considered. Addressing the question of whether UKA is able to restore normal knee mechanics compared with TKA, UKA patients in a study by Jung et al [16] performed stair climbing with similar knee internal rotation in their operated knee to the non-operated knee (non-OP knee) in contrast to TKA patients. A recent study [17] used a machine learning approach to classify and identify UKA and TKA knees on the basis of recognized patterns.…”

Section: Introductionmentioning

confidence: 99%

Non-Sagittal Knee Joint Kinematics and Kinetics during Gait on Level and Sloped Grounds with Unicompartmental and Total Knee Arthroplasty Patients

et al. 2016

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After knee arthroplasty (KA) surgery, patients experience abnormal kinematics and kinetics during numerous activities of daily living. Biomechanical investigations have focused primarily on level walking, whereas walking on sloped surfaces, which is stated to affect knee kinematics and kinetics considerably, has been neglected to this day. This study aimed to analyze over-ground walking on level and sloped surfaces with a special focus on transverse and frontal plane knee kinematics and kinetics in patients with KA. A three-dimensional (3D) motion analysis was performed by means of optoelectronic stereophogrammetry 1.8 ± 0.4 years following total knee arthroplasty (TKA) and unicompartmental arthroplasty surgery (UKA). AnyBody™ Modeling System was used to conduct inverse dynamics. The TKA group negotiated the decline walking task with reduced peak knee internal rotation angles compared with a healthy control group (CG). First-peak knee adduction moments were diminished by 27% (TKA group) and 22% (UKA group) compared with the CG during decline walking. No significant differences were detected between the TKA and UKA groups, regardless of the locomotion task. Decline walking exposed apparently more abnormal knee frontal and transverse plane adjustments in KA patients than level walking compared with the CG. Hence, walking on sloped surfaces should be included in further motion analysis studies investigating KA patients in order to detect potential deficits that might be not obvious during level walking.

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Difference in knee rotation between total and unicompartmental knee arthroplasties during stair climbing

Abstract: Both UKA and TKA knees have shown overall similar knee kinematics, though UKA knee may allow greater degree of rotation freedom, which resembles normal knee kinematics during stair walking.

Cited by 17 publications

References 31 publications

Compromised knee internal rotation in total knee arthroplasty patients during stair climbing

Compromised knee internal rotation in total knee arthroplasty patients during stair climbing

A comparison of gait characteristics between posterior stabilized total knee and fixed bearing unicompartmental knee arthroplasties

Non-Sagittal Knee Joint Kinematics and Kinetics during Gait on Level and Sloped Grounds with Unicompartmental and Total Knee Arthroplasty Patients

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