Patient-specific versus off-the-shelf unicompartmental knee arthroplasty during level walking

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-08-27 DOI:10.1002/jeo2.70347

Haithem M'barki, Etienne L. Belzile, Katia Turcot

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引用次数: 0

Abstract

Purpose

Personalised unicompartmental knee arthroplasty (UKA) improves tibial implant positioning and clinical outcomes compared to an off-the-shelf UKA. However, no biomechanical study has confirmed the functional superiority of custom implants. The study aimed to assess potential differences between personalised and off-the-shelf UKA in knee joint function in terms of both biomechanical and clinical outcomes during level walking.

Methods

Twenty-two patients and 22 healthy individuals (control group [CG]), matched for age and height, were recruited. Eight patients were implanted with a Bodycad UKS (BUKS) prosthesis, and 14 patients with an Oxford UKA (OUKA) prosthesis. Participants walked barefoot along a 10 m walkway. To quantify 3D kinematics and kinetics, a 10-camera motion analysis system and four force plates were used. The knee injury and osteoarthritis outcome score (KOOS) was utilised to measure knee function. 3D lower limbs angles and moments were estimated, and total support moment (TSM) was calculated. Biomechanical outcomes were compared along the gait cycle (GC) (0%–100%) between groups using statistical parametric mapping (SPM).

Results

The results showed higher KOOS total score for BUKS compared to OUKA (p = 0.020, effect size [ES] = 0.62). No significant differences were observed between BUKS and OUKA for the biomechanical variables (p > 0.05). Significant decrease of knee extension angle for OUKA compared to CG between 27% and 46% of GC (p < 0.001) was observed. Knee moments showed a significant decrease for the external knee flexor moment for OUKA compared to CG between 55% and 76% of the stance phase (SP) (p < 0.001). A reduction of the contribution of the knee to the first peak of TSM was observed for both BUKS and OUKA compared to CG (p = 0.019, ES = 0.34).

Conclusions

BUKS patients demonstrated similar knee function compared to OUKA. OUKA group exhibited a protective mechanism by reducing the knee extension. Neither BUKS nor OUKA restored knee joint function comparable to a native knee, with compensation mechanism occurring through adjacent joints.

Level of Evidence

Level III.

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水平行走期间患者特异性与现成单室膝关节置换术的对比

与现成的单室膝关节置换术（UKA）相比，个性化单室膝关节置换术（UKA）可改善胫骨植入物定位和临床效果。然而，没有生物力学研究证实定制植入物的功能优势。该研究旨在评估个性化和现成的UKA在水平行走时膝关节功能的生物力学和临床结果方面的潜在差异。方法选取年龄、身高相匹配的患者22例，对照组22例。8例患者植入Bodycad UKS （BUKS）假体，14例患者植入Oxford UKA （OUKA）假体。参与者赤脚走在10米长的人行道上。为了量化三维运动学和动力学，使用了一个10摄像头运动分析系统和四个力板。膝关节损伤和骨关节炎结局评分（oos）用于测量膝关节功能。估计三维下肢角度和力矩，计算总支撑力矩（TSM）。采用统计参数映射法（SPM）比较各组沿步态周期（GC）（0%-100%）的生物力学结果。结果BUKS组的KOOS总分高于OUKA组（p = 0.020，效应量[ES] = 0.62）。BUKS和OUKA在生物力学变量上无显著差异（p > 0.05）。与CG相比，OUKA患者的膝关节伸角明显降低，为GC的27%至46% （p < 0.001）。与CG相比，OUKA的膝关节外屈肌力矩在站立阶段（SP）的55%至76%之间显著降低（p < 0.001）。与CG相比，BUKS和OUKA组膝关节对TSM第一个峰值的贡献减少（p = 0.019, ES = 0.34）。结论：与OUKA相比，BUKS患者表现出相似的膝关节功能。OUKA组通过减少膝关节伸展表现出保护机制。BUKS和OUKA修复的膝关节功能都不能与天然膝关节相比，而是通过相邻关节进行补偿。证据等级三级。

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