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Research

THE EXTENSOR EFFICIENCY OF UNICOMPARTMENTAL, BICOMPARTMENTAL, AND TOTAL KNEE ARTHROPLASTY

The British Orthopaedic Research Society (BORS) Annual Meeting 2020, held online, 7–8 September 2020.



Abstract

Abstract

Objectives

Unicompartmental (UKA) and bicompartmental (BCA) knee arthroplasty are associated with improved functional outcomes compared to Total Knee Arthroplasty (TKA) in suitable patients, although the reason is poorly understood. The aim of this study was to measure how the different arthroplasties affect knee extensor function.

Methods

Extensor function was measured for sixteen cadaveric knees and then re-tested following the different arthroplasties. Eight knees underwent medial UKA then BCA, then posterior-cruciate retaining TKA, and eight underwent the lateral equivalents then TKA. Extensor efficiency was calculated for ranges of knee flexion associated with common activities of daily living. Data were analyzed with repeated measures analysis of variance (α=0.05).

Results

Compared to native, no differences were detected in either extensor moment or efficiency following UKA. Conversion to BCA resulted in a small drop in extensor moment between 70-90° flexion (p<0.05), but when examined in the context of daily activity ranges of flexion, extensor efficiency was largely unaffected. Following TKA, large decreases in extensor moment were measured at low knee flexion angles (p<0.05), resulting in 8–43% reduction in extensor efficiency for daily activity ranges.

Conclusion

This cadaveric study found that TKA is associated with inferior extensor function compared to UKA and BCA. This may, in part, help explain the reported differences in function and satisfaction differences between partial and total knee arthroplasty.

Declaration of Interest

(a) fully declare any financial or other potential conflict of interest