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J Knee Surg 2022; 35(08): 896-903
DOI: 10.1055/s-0040-1721033
Original Article

Evaluation of Knee Kinematics and Moments during Active Deep Flexion Activity after Oxford Mobile-Bearing Medial UKA—A Two-Year Follow-Up Study

Li Yue 
1   Department of Orthopaedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, P.R. China
2   School of Human Kinetics, University of Ottawa, Ottawa Ontario, Canada
,
Mario Lamontagne
2   School of Human Kinetics, University of Ottawa, Ottawa Ontario, Canada
,
Zhao Xiong
2   School of Human Kinetics, University of Ottawa, Ottawa Ontario, Canada
,
Zhu Zhengfei
3   State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
,
Tian Run
1   Department of Orthopaedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, P.R. China
,
Li Zhe
1   Department of Orthopaedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, P.R. China
,
Kong Ning
1   Department of Orthopaedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, P.R. China
,
Wang Chunsheng
1   Department of Orthopaedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, P.R. China
,
Yang Pei
1   Department of Orthopaedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, P.R. China
,
Wang Kunzheng
1   Department of Orthopaedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, P.R. China
› Author Affiliations Funding This study was supported by National Natural Science Foundation of China (General Program 81672173).
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Abstract

Few studies have assessed knee range of motion (ROM) and moments of patients with mobile-bearing unicompartmental knee arthroplasty (MB UKA) during active deep flexion activities. We analyze knee kinematic and kinetic parameters during postoperative squatting-standing activity, aiming to evaluate the efficacy of MB UKA and postoperative rehabilitation progress. This was a clinical cohort study. We followed up with 37 patients diagnosed with medial knee osteoarthritis (OA) with primary UKA. After screening 31 patients were recruited to take gait tests. Squatting-standing activities were performed under the test of 10-camera motion analysis system and force plates preoperatively at different stages after UKA (12, 18, and 24 months). The average duration of follow-up was 24.4 months (from 22.8 to 26.7 months). Hip-knee-ankle angle improved significantly compared with pre-UKA as well as scores of American Knee Society Score, numeric rating scale, ORS, and Western Ontario and McMasters. University Osteoarthritis Index. About 83.6% (31/37) of follow-up patients completed squatting-standing activity independently. At 1-year follow-up, peak varus angle (20.6 ± 2.8 degrees), internal rotation angle (13.6 ± 1.8 degrees), extensor moment (1.44 ± 0.04N*m/kg), and internal rotator moment (0.02 ± 0.005N*m/kg) of UKA knees were inferior to contralateral knees. Peak adductor moment (0.76 ± 0.05N*m/kg) was superior to contralateral knees. At 2-year follow-up, peak flexion angle (125.0 ± 2.8 degrees) showed a growing trend meanwhile extensor (1.70 ± 0.03N*m/kg) and adductor (0.68 ± 0.06 N*m/kg) moment closely resembled those of the contralateral knee. MB UKA could alleviate the affected knee mainly in flexion-extension ROM and moment meanwhile did not affect the biomechanical indicators of healthy limbs. OA knees in the early postoperative period showed decreased extensor moment and increased adductor moment during active deep flexion activity. Better ROM and relatively more natural extensor and adductor moment of UKA knee with rehabilitation time increasing may predict ideal rehabilitation outcome in the medium or longer term.

Keywords

unicompartmental knee arthroplasty - kinematics - range of motion - kinetics - moments - deep flexion - functional outcome


Publication History

Received: 17 September 2018

Accepted: 05 October 2020

Article published online:
05 January 2021

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