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Unicompartmental knee arthroplasty fails to completely restore normal gait patterns during level walking

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Gait analysis is a valuable instrument for measuring function objectively after unicompartmental knee arthroplasty (UKA). However, most gait analysis studies have reported conflicting results for functional assessment after UKA. This meta-analysis compared the gait patterns of UKA patients and healthy controls during level walking.

Methods

Studies were included in the meta-analysis if they recorded vertical ground reaction force (GRF), flexion at initial contact, flexion at loading response, extension at mid-stance, flexion at swing, walking speed, cadence, and stride length in UKA patients or healthy controls.

Results

Seven studies met the criteria for inclusion in the meta-analysis. The UKA patients and healthy controls were similar in terms of vertical GRF (95% CI − 0.54 to 0.23; ns), flexion at initial contact (95% CI − 0.47 to 4.96; ns), flexion at loading response (95% CI − 1.29 to 3.69; ns), and flexion at swing (95% CI − 8.85 to 0.40; ns). In contrast, extension at mid-stance (95% CI 0.53 to 4.88; P = 0.01), walking speed (95% CI − 2.13 to − 0.15; P = 0.02), cadence (95% CI − 1.02 to − 0.25; P = 0.001), and stride length (95% CI − 2.02 to − 0.22; P = 0.01) differed significantly between groups. Subgroup analyses revealed that the pooled data were similar between groups: 1st maximum (heel strike), − 0.43 BW (ns); 1st minimum (mid-stance), 0.61 BW (ns); and 2nd maximum (toe off), − 0.46 BW (ns).

Conclusions

There were no significant differences in vertical GRF or overall kinematics in the sagittal plane between UKA patients and healthy controls during level walking. However, the UKA group had a significantly slower walking speed and cadence and a shorter stride length than healthy controls. The current findings suggest that, clinically, UKA fails to completely restore normal gait patterns.

Level of evidence

Level II, therapeutic study.

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Acknowledgements

This work was supported by Inha University Hospital Research Grant. The authors would like to thank Ms. Jae-Ok Park for her help in preparing the manuscript.

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Author notes

  1. Myung-Ku Kim and Jung-Ro Yoon contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Inha University Hospital, Incheon, Republic of Korea

    Myung-Ku Kim

  2. Department of Orthopedic Surgery, Veterans Health Service Medical Center, 61 Jinhwangdoro-gil, Gangdong-Gu, Seoul, 134-791, Republic of Korea

    Jung-Ro Yoon, Se-Hyun Yang & Young-Soo Shin

Authors
  1. Myung-Ku Kim
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  2. Jung-Ro Yoon
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Correspondence to Young-Soo Shin.

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The authors declare that they have no conflict of interest.

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For this retrospective study, ethical approval is not required.

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Kim, MK., Yoon, JR., Yang, SH. et al. Unicompartmental knee arthroplasty fails to completely restore normal gait patterns during level walking. Knee Surg Sports Traumatol Arthrosc 26, 3280–3289 (2018). https://doi.org/10.1007/s00167-018-4863-0

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  • DOI: https://doi.org/10.1007/s00167-018-4863-0

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