Department of Kinesiology, The University of Georgia, Athens, GA, USA.
Clin Orthop Relat Res. 2013 Jan;471(1):142-9. doi: 10.1007/s11999-012-2522-1.
Unicompartmental knee arthroplasty (UKA) has long been a treatment option for patients with disease limited primarily to one compartment with small, correctable deformities. However, some surgeons presume that normal kinematics of a lateral compartment UKA are difficult to achieve. Furthermore, it is unclear whether UKA restores normal knee kinematics and interlimb symmetry.
QUESTIONS/PURPOSES: We determined knee kinematics exhibited during stair ascent by patients with medial- (MED-UKA) or lateral-UKA (LAT-UKA) and if the knee kinematics of the operated and nonoperated limbs were symmetrical.
Participants were 17 individuals with MED-UKA and nine with LAT-UKA, all with nondiseased contralateral limbs. For each limb, participants walked up four stairs for five trials while a motion-capture system obtained reflective marker locations. Temporal events were determined by force platform signals. Interlimb symmetry was classified for temporal gait and knee angular kinematics by comparing observed interlimb differences with clinically meaningful differences set at 5% of stride time for temporal variables and 5° for angular variables. The minimum postoperative followup was 6 months (median, 24 months; range, 6-53 months).
Neither group demonstrated clinically meaningful mean interlimb differences. However, approximately half of participants of each UKA group displayed asymmetry favoring the operative or nonoperative limb with similar frequency.
Many patients undergoing UKA demonstrate kinematic interlimb symmetry during stair ascent. Interlimb asymmetry may be affected by a variety of factors unrelated to the UKA.
A MED- or LAT-UKA can potentially restore normal knee function for a demanding task of daily life.
单髁膝关节置换术（UKA）长期以来一直是一种治疗选择，适用于主要局限于一个间室且存在小而可纠正畸形的患者。然而，一些外科医生认为很难实现外侧间室 UKA 的正常运动学。此外，UKA 是否能恢复正常的膝关节运动学和肢体间对称性尚不清楚。
问题/目的：我们确定了内侧（MED-UKA）或外侧 UKA（LAT-UKA）患者在爬楼梯时膝关节的运动学情况，以及手术和未手术肢体的膝关节运动学是否对称。
参与者为 17 例 MED-UKA 和 9 例 LAT-UKA 患者，所有患者均有未患病的对侧肢体。对于每一条肢体，参与者在 5 次试验中每条腿上爬 4 级楼梯，同时运动捕捉系统获取反射标记位置。力台信号确定时间事件。通过比较观察到的肢体间差异与设定的 5%步长时间的时间变量和 5°的角度变量的临床有意义差异，对时间步态和膝关节角度运动学的肢体间对称性进行分类。最小术后随访时间为 6 个月（中位数，24 个月；范围，6-53 个月）。
两个 UKA 组均未表现出有临床意义的平均肢体间差异。然而，每组大约一半的参与者表现出偏向手术或非手术肢体的对称性，其频率相似。
许多接受 UKA 的患者在爬楼梯时表现出运动学肢体间对称性。肢体间不对称可能受与 UKA 无关的多种因素影响。
MED 或 LAT-UKA 可为日常生活中具有挑战性的任务潜在地恢复正常的膝关节功能。
