Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2012

01-06-2012 | Knee

Muscle activity around the knee and gait performance in unicompartmental knee arthroplasty patients: a comparative study on fixed- and mobile-bearing designs

Authors: Fabio Catani, Maria Grazia Benedetti, Luca Bianchi, Valentina Marchionni, Sandro Giannini, Alberto Leardini

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2012

Login to get access

Abstract

Purpose

Unicompartmental knee arthroplasty (UKA) offers clinical and functional advantages over total knee arthroplasty. The aim of this study was to compare the functional recovery of patients with mobile UKA versus fixed-bearing designs by state-of-the-art gait analysis and, in particular, by assessing muscular activity.

Methods

Ten patients with the Oxford (mobile bearing) and ten patients with Optetrak (fixed bearing) UKA were evaluated at a minimum follow-up of 1 year post-operatively by gait analysis, which includes the main time–distance parameters, kinematics and kinetics of the replaced knee, and muscular activity of the main relevant muscles. Twenty healthy young subjects were used as controls.

Results

The mean International Knee Society score was 92.7 ± 11.2 for all 20 UKA knees; for the Oxford UKA, it was 94.1 ± 9.5; and for the Optetrak UKA, it was 91.5 ± 12.9, although follow-up was significantly lower for the latter. Time–distance parameters showed a slower gait in both groups compared with that of controls, and the Oxford group had values closer to the controls. Knee joint flexion was similar to that of controls at initial contact and loading response with no differences between groups. In all patients, the joint moments were smaller to that of controls. Residual abnormalities such as the prolonged rectus femoris activity were present in both designs, and the only difference distinguishing the Optetrak group from the others was the combined co-contraction of the hamstrings.

Conclusions

A good restoration of gait was achieved by most unicompartmental knee patients independently of the UKA design, although some abnormalities persisted in muscle activity around the knee.

Level of evidence

Retrospective comparative study, Level III.
Literature
1.
Argenson JN, Komistek RD, Aubaniac JM, Dennis DA, Northcut EJ, Anderson DT, Agostini S (2002) In vivo determination of knee kinematics for subjects implanted with a unicompartmental arthroplasty. J Arthroplasty 17:1049–1054PubMedCrossRef
2.
Banks SA, Fregly BJ, Boniforti F, Reinschmidt C, Romagnoli S (2005) Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacements. Knee Surg Sports Traumatol Arthrosc 13:551–556PubMedCrossRef
3.
Benedetti MG, Catani F, Bilotta TW, Marcacci M, Mariani E, Giannini S (2003) Muscle activation pattern and gait biomechanics after total knee replacement. Clin Biomech 18:871–876CrossRef
4.
Benedetti MG, Catani F, Leardini A, Pignotti E, Giannini S (1998) Data management in gait analysis for clinical applications. Clin Biomech 13:204–215CrossRef
5.
Bonato P, Knaflitz M, D’Alessio T (1998) A statistical method for the measurement of muscle activation intervals from surface myoelectric signal during gait. IEEE Trans Biomed Eng 45:287–299PubMedCrossRef
6.
Borjesson M, Weidenhielm L, Mattsson E, Olsson E (2005) Gait and clinical measurement in patients with knee osteoarthritis after surgery: a prospective 5-year follow-up study. Knee 12:121–127PubMedCrossRef
7.
Borus T, Thornhill T (2008) Unicompartmental knee arthroplasty. J Am Acad Orthop Surg 16:9–18PubMed
8.
Chassin EP, Mikosz RP, Andriacchi TP, Rosenberg AG (1996) Functional analysis of cemented medial unicompartmental knee arthroplasty. J Arthroplasty 11:553–559PubMedCrossRef
9.
Collier MB, Anderson Engh C, McAuley JP, Engh GA (2007) Factors associated with the loss of thickness of polyethylene tibial bearing after knee arthroplasty. J Bone Joint Surg Am 89:1306–1314PubMedCrossRef
10.
Confalonieri N, Manzotti A, Pullen C (2004) Comparison of a mobile with a fixed tibial bearing unicompartmental knee prosthesis: a prospective randomized trial using a dedicated outcome score. Knee 11:357–362PubMedCrossRef
11.
Emerson RH, Hansborought T, Reitman RD, Rosenfeldt W, Higgins LL (2002) Comparison of a mobile with a fixed bearing unicompartmental knee implant. Clin Orthop Relat Res 404:62–70PubMedCrossRef
12.
Fisher DA, Dalury DF, Adams MJ, Shipps MR, Davis K (2010) Unicompartmental and total knee arthroplasty in the over 70 population. Orthopedics 33(9):668PubMed
13.
Fuchs S, Tibesku CO, Frisse D, Genkinger M, Laaß H, Rosenbaum D (2005) Clinical and functional comparison of uni- and bicondylar sledge prostheses. Knee Surg Sports Traumatol Arthrosc 13:197–202PubMedCrossRef
14.
Fuchs S, Frisse D, Laass H, Thorwesten L, Tibesku CO (2004) Muscle strength in patients with unicompartmental arthroplasty. Am J Phys Med Rehabil 83:650–654PubMedCrossRef
15.
Gleeson RE, Evans R, Ackroyd CE, Webb J, Newman JH (2004) Fixed or mobile bearing unicompartmental knee replacement? A comparative cohort study. Sci Direct 11:379–384
16.
Hanson GR, Moynihan AL, Suggs JF, Kwon YM, Johnson T, Li G (2009) Kinematics of medial unicondylar knee arthroplasty: an in vivo investigation. J Knee Surg 22:237–242PubMedCrossRef
17.
Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rational of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14PubMed
18.
Jefferson RJ, Whittle MW (1989) Biomechanical assessment of unicompartmental knee arthroplasty, total condylar arthroplasty and tibial osteotomy. Clin Biomech 4:232–242CrossRef
19.
Kleijn LL, van Hemert WL, Meijers WG, Kester AD, Lisowski L, Grimm B, Heyligers IC (2007) Functional improvement after unicompartmental knee replacement: a follow-up study with a performance based knee test. Knee Surg Sports Traumatol Arthrosc 15:1187–1193PubMedCrossRef
20.
Kozinn SC, Scott RD (1989) Unicondylar knee arthroplasty. J Bone Joint Surg Am 71A:145–150
21.
Leardini A, Sawacha Z, Paolini G et al (2007) A new anatomically based protocol for gait analysis in children. Gait Posture 26:560–571PubMedCrossRef
22.
Li MG, Yao F, Joss B, Ioppolo J, Nivbrant B, Wood D (2006) Mobile vs. fixed bearing unicondylar knee arthroplasty: a randomized study on short term clinical outcomes and knee kinematics. Knee 13:365–370PubMedCrossRef
23.
Lindstrom M, Fellander-Tsai L, Wredmark T, Henriksson M (2010) Adaptations of gait and muscle activation in chronic ACL deficiency. Knee Surg Sports Traumatol Arthrosc 18:106–114PubMedCrossRef
24.
Manca M, Leardini A, Cavazza S, Ferraresi G, Marchi P, Zanaga E, Benedetti MG (2010) Repeatability of a new protocol for gait analysis in adult subjects. Gait Posture 32:282–284PubMedCrossRef
25.
Mattsson E, Olsson E, Broström L-Å (1990) Assessment of walking before and after unicompartmental knee arthroplasty. Scand J Rehab Med 22:45–50
26.
McClelland JA, Webster KE, Feller JA (2007) Gait analysis of patients following total knee replacement: a systematic review. Knee 14:253–263PubMedCrossRef
27.
Patil S, Colwell CW Jr, Ezzet KA, D’Lima DD (2005) Can normal knee kinematics be restored with unicompartmental knee replacement? J Bone Joint Surg Am 87:332–338PubMedCrossRef
28.
Price AJ, Oppold PT, Murray DW, Zavatsky AB (2006) Simultaneous in vitro measurement of patellofemoral kinematics and forces following Oxford medial unicompartmental knee replacement. J Bone Joint Surg Br 88:1591–1595PubMedCrossRef
29.
Psychoyios V, Crawford RW, O’Connor JJ, Murray DW (1998) Wear of congruent meniscal bearings in unicompartmental knee arthroplasty. J Bone Joint Surg Br 80-B:876–882
30.
Saccomanni B (2010) Unicompartmental knee arthroplasty: a review of literature. Clin Rheumatol 29:339–346PubMedCrossRef
31.
Smith TO, Hing CB, Davies L, Donell ST (2009) Fixed versus mobile bearing unicompartmental knee replacement: a meta analysis. Orthop Traumatol Surg Res 95:599–605PubMedCrossRef
32.
Stevens-Lapsley JE, Balter JE, Kohrt WM, Eckhoff DG (2010) Quadriceps and hamstrings muscle dysfunction after total knee arthroplasty. Clin Orthop Relat Res 468:2460–2468PubMedCrossRef
33.
Suggs JF, Li G, Park SE, Sultan PG, Rubasi HE, Freiberg AA (2006) Knee biomechanics after UKA and its relation to the ACL-A robotic investigation. J Orthop Res 24:588–594PubMedCrossRef
34.
Webster KE, Wittwer JE, Feller JA (2003) Quantitative gait analysis after medial unicompartmental knee arthroplasty for osteoarthritis. J Arthroplasty 6:751–759CrossRef
35.
Weidenhielm L, Olsson E, Broström LA, Börjesson-Hederström M, Mattsson E (1993) Improvement in gait one year after surgery for knee osteoarthrosis: a comparison between high tibial osteotomy and prosthetic replacement in a prospective randomized study. Scand J Rehabil Med 25:25–31PubMed
36.
Weinstein JN, Andriacchi TP, Galante JO (1986) Factors influencing walking and stair climbing following unicompartmental knee arthroplasty. J Arthroplasty 1:109–115PubMedCrossRef
37.
Whittle MW, Jefferson RJ (1989) Functional biomechanics assessment of the Oxford meniscal knee. J Arthroplasty 4:231–243PubMedCrossRef
Metadata
Title
Muscle activity around the knee and gait performance in unicompartmental knee arthroplasty patients: a comparative study on fixed- and mobile-bearing designs
Authors
Fabio Catani
Maria Grazia Benedetti
Luca Bianchi
Valentina Marchionni
Sandro Giannini
Alberto Leardini
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2012
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1620-z

Other articles of this Issue 6/2012

Knee Surgery, Sports Traumatology, Arthroscopy 6/2012 Go to the issue

Shoulder

Closed proximal muscle rupture of the biceps brachii in wakeboarders

Knee

Variability in leg muscle power and hop performance after anterior cruciate ligament reconstruction

Knee

Extended sagittal saw cut significantly reduces fracture load in cementless unicompartmental knee arthroplasty compared to cemented tibia plateaus: an experimental cadaver study

Shoulder

Acromioclavicular motion after surgical reconstruction

Knee

Lower limb proprioception deficits persist following knee replacement surgery despite improvements in knee extension strength

Knee

Early magnetic resonance imaging in acute knee injury: a cost analysis