Our Summary

This research paper compares the walking patterns of patients who have undergone two different types of knee replacement surgeries: total knee arthroplasty (TKA) and unicondylar knee arthroplasty (UKA). The study involved 13 patients with TKA and 14 with UKA. Their walking movements were analyzed using a motion-tracking system.

The findings showed that patients with UKA had a greater range of motion in their knees and could extend their knees more during the stance phase (the portion of the walking cycle where the foot is grounded and bears weight) compared to the TKA patients. They also had improved knee bending when walking compared to their non-operated knee. Their hips also showed nearly normal bending movements.

However, as expected, the UKA knees were more bowed compared to the TKA knees. Despite walking a bit stiffly, the TKA patients had a more neutral alignment in their knees. The walking speed and step length were similar for both groups, ensuring a fair comparison.

In conclusion, the UKA knees had a greater range of motion and moved more naturally while walking, but the TKA knees had a better alignment. However, neither surgery fully restored the knee movements to match the non-operated side.

FAQs

  1. What are the two types of knee replacement surgeries compared in this research?
  2. How do the walking patterns of patients with total knee arthroplasty (TKA) differ from those with unicondylar knee arthroplasty (UKA)?
  3. According to the study, do either of the surgeries fully restore knee movements to match the non-operated side?

Doctor’s Tip

A helpful tip a doctor might give a patient about knee replacement is to follow the prescribed rehabilitation program diligently. This will help improve strength, flexibility, and range of motion in the knee, leading to better overall function and mobility. Additionally, maintaining a healthy weight and staying active through low-impact exercises like walking or swimming can help support the knee joint and prevent further complications. Regular follow-up appointments with your doctor and physical therapist are also important to monitor progress and address any concerns.

Suitable For

Patients who are typically recommended for knee replacement surgery are those who are experiencing severe knee pain and stiffness that limits their ability to perform daily activities, such as walking, climbing stairs, or getting in and out of chairs. These patients may also have arthritis or other degenerative conditions affecting the knee joint.

Specific criteria for recommending knee replacement surgery may include:

  • Severe knee pain that is not relieved by conservative treatments such as medication, physical therapy, or injections
  • Significant loss of knee function, such as difficulty walking or bending the knee
  • Joint deformity, instability, or swelling
  • Failure to respond to other surgical procedures, such as arthroscopic surgery or cartilage repair
  • Radiographic evidence of advanced joint damage or arthritis

Ultimately, the decision to undergo knee replacement surgery is made on a case-by-case basis by a healthcare provider, taking into consideration the individual patient’s symptoms, medical history, and overall health.

Timeline

Before knee replacement:

  1. Patient experiences chronic knee pain, stiffness, and reduced mobility.
  2. Patient undergoes consultations with orthopedic surgeons to determine the need for knee replacement.
  3. Pre-operative tests and assessments are conducted to ensure the patient is a suitable candidate for surgery.
  4. Patient undergoes knee replacement surgery, either TKA or UKA.
  5. Post-surgery, patient is monitored in the hospital for a few days for pain management and rehabilitation.

After knee replacement:

  1. Patient undergoes physical therapy and rehabilitation to regain strength and mobility in the knee.
  2. Patient is discharged from the hospital and continues rehabilitation at home or in outpatient therapy.
  3. Patient gradually increases activity level and mobility, with the goal of returning to normal activities.
  4. Follow-up appointments with the surgeon are scheduled to monitor the healing process and address any concerns.
  5. Over time, patient experiences improved knee function, reduced pain, and increased mobility in the replaced knee.
  6. Patient is able to resume daily activities and potentially return to more strenuous activities such as sports or exercise.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with knee replacement surgery?
  2. How long is the recovery period and what can I expect in terms of pain management?
  3. Will I need physical therapy after the surgery and for how long?
  4. What restrictions or limitations should I be aware of after the surgery?
  5. How long can I expect the knee replacement to last and what factors can affect its longevity?
  6. Will I need any assistive devices, such as a cane or walker, after the surgery?
  7. How soon can I return to normal activities, such as driving or exercising?
  8. Are there any specific exercises or movements I should avoid after the surgery?
  9. How often will I need follow-up appointments after the surgery?
  10. What are the signs of complications or issues that I should watch out for post-surgery?

Reference

Authors: Agarwal A, Miller S, Hadden W, Johnston L, Wang W, Arnold G, Abboud RJ. Journal: Ann R Coll Surg Engl. 2019 Jul;101(6):391-398. doi: 10.1308/rcsann.2019.0016. Epub 2019 Jun 3. PMID: 31155888