Comparison Of Gait And Balance In Unicompart Mental Knee Arthroplasty And Total Knee Arthro Plasty

Objective : To compare the gait and balance of unicompartmental knee arthroplasty(UKA)and total knee arthroplasty(TKA)in the treatment of medial compartment osteoarthritis of knee joint,so as to provide biomechanical basis for clinical selection of appropriate arthroplasty.Methods:A retrospective study of 70 patients with knee arthroplasty 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.35 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 average follow-up period was(23.5±14.8)months.The TKA group included 13 males and 22 females with an average age of(65.0±6.1)years old.The average follow-up period was(23.3±14.8)months.In the control group,there were 16 males and 19 females with an average age of(64.6±7.1)years.All 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,center of pressure(COP)path length,90 %COP postural sway area.One-way ANOVA and Tukey test wasapplied 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 between UKA group and TKA group.Results:the average follow-up time was(23.5 ± 14.8)months in UKA group and(23.3 ± 14.8)months in TKA group.All patients had no prosthesis loosening,sinking,dislocation and contralateral compartment disease.There was no significant difference in age,sex ratio,BMI and preoperative HSS scores among the three groups.The single-limb support phase(SLS),COP path length and90 %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 and90 %COP postural sway area between the UKA group and the control group(P<0.05).Conclusion: UKA results in a more physiological gait and better stability compared with TKA,but there are still differences between UKA and normal elderly.