Comparison of spatiotemporal, kinematic, and kinetic gait characteristics in total and unicompartmental knee arthroplasty during level walking: A systematic review and meta-analysis

Purpose: This meta-analysis was performed to compare the spatiotemporal, kinematic, and kinetic gait charac-teristics during level walking between total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA).Methods: An electronic database literature search was performed to screen clinical trials which were included the studies evaluating not only spatiotemporal, kinematic, and kinetic gait parameters, but also knee range of motion and knee score (Knee Society Score and Oxford Knee Score, i.e., KSS and OKS). The data analysis was performed using statistical software Stata 14.0 and Review Manager 5.4.Results: Thirteen studies (369 knees) that met the criteria were eventually included in this meta-analysis. The results revealed significant differences between UKA and TKA with regard to walking speed (P = 0.04), stride length (P = 0.02), maximum knee flexion at loading (P = 0.001), the 1st peak of vert-GRF (P = 0.006), the 1st valley of vert-GRF (P = 0.007), knee internal rotational moment (P = 0.04), knee extension (P < 0.00001), and KSS Function score (P = 0.05). In contrast, there were no statistical differences in the remaining spatiotemporal, kinematic, and kinetic gait parameters.Conclusion: Medial UKA design is superior to TKA design with regard to walking speed, stride length, maximum knee flexion at loading, the 1st peak and the 1st valley of vert-GRF, knee internal rotational moment, knee extension, and KSS Function score. And it could provide a stronger basis for physicians to make clinical decisions.

Automated summary

This meta-analysis compares the gait characteristics between total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) during level walking. The results show that the medial UKA design is superior to TKA design in terms of walking speed, stride length, maximum knee flexion at loading, the first peak and valley of vertical ground reaction force, knee internal rotational moment, knee extension, and KSS Function score.