5-year gait analysis as a secondary outcome of a fixed bearing robotic assisted versus mobile bearing manual UKA RCT

Banger, Matthew and Rowe, Philip and Millar, Lindsay and Blyth, Mark and Maclean, Angus and Jones, Bryn and Donnelly, Iona (2018) 5-year gait analysis as a secondary outcome of a fixed bearing robotic assisted versus mobile bearing manual UKA RCT. EPiC Series in Health Sciences, 2. pp. 1-5. ISSN 2398-5305

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Abstract

Total knee arthroplasty (TKA) procedures have recognised differences in knee kinematics and kinetics from healthy knees. This study reports on the less documented knee kinematics and kinetics of uni-compartmental knee arthroplasty (UKA) patients during walking as a secondary outcome measure of a RCT between a fixed bearing UKA robotic procedure versus a mobile bearing UKA manual procedure. Three dimensional, instrumented, gait analysis was performed 5 years after 49 medial osteoarthritis UKA patients received surgery. 27 were randomised to receive a robotic assisted UKA and 22 to receive a manual implant surgery. The robotic assisted group showed a significant increased range of motion in stance during walking. 59% of the robotic assisted group achieved a bi-phasic sagittal knee moment, in comparison of 50% of the manual group. Significantly higher peak values of the varus knee and internal rotation moments were measured for the robotic assisted group during early and late section of the gait cycle, respectively. This indicates that larger normalised forces are applied through the knee during flat ground walking in the robotic assisted group. The robotic assisted group showed biomechanical benefits over the manual group for walking tasks. Poor fixation outcomes are avoided in patients with normal knee moments.