Does interlimb knee symmetry exist after unicompartmental knee arthroplasty?

BACKGROUND

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.

METHODS

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).

RESULTS

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.

CONCLUSIONS

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.

CLINICAL RELEVANCE

A MED- or LAT-UKA can potentially restore normal knee function for a demanding task of daily life.