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Knee strength, power and stair performance of the elderly 5 years after unicompartmental knee arthroplasty

  • Original Article • KNEE - ARTHROPLASTY
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Unicompartmental knee arthroplasty (UKA) has been shown to demonstrate some satisfactory short-term outcomes. However, to our knowledge, there have been no reports on midterm or long-term knee extensor strength and leg extensor power post-UKA.

Aims

Therefore, the purposes of this study were: (1) to assess the isokinetic knee extensor strength, leg extensor power and stair performance of elderly participants at 5 years UKA post-operation; (2) to compare the differences in knee extensor strength and leg extensor power between the UKA and contralateral healthy limbs.

Methods

Nineteen elderly participants (75 ± 5 years) who had a medial or a lateral compartment UKA at 5 years post-operation were recruited. The isokinetic knee extensor strength and leg extensor power were measured. The stair performance was tested on a 4-step stair, and ascent and descent velocities were calculated. The pain level was assessed.

Results

The UKA limbs’ knee extensor strength and leg extensor power were 1.01 ± 0.39 Nm/kg and 0.98 ± 0.27 W/kg, respectively. The stair ascent and descent velocities were 0.37 ± 0.07 and 0.38 ± 0.11 m/s, respectively. In addition, the UKA limbs exhibited comparable knee strength and leg power relative to the contralateral limbs.

Discussion

In general, the knee extensor strength and leg extensor power exhibited by the UKA limbs at 5 years post-operation may be typical in comparison with the normative data.

Conclusions

We suggest that UKA is a satisfactory treatment in regard to the recovery of knee strength, leg power and ability to climb up and down stairs.

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References

  1. Fetzer GB, Callaghan JJ, Templeton JE et al (2002) Posterior cruciate–retaining modular total knee arthroplasty: a 9- to 12-year follow-up investigation. J Arthroplasty 17:961–966. https://doi.org/10.1054/arth.2002.34824

    Article  PubMed  Google Scholar 

  2. Aglietti P, Buzzi R, De Felice R, Giron F (1999) The Insall-Burstein total knee replacement in osteoarthritis: a 10-year minimum follow-up. J Arthroplasty 14:560–565

    Article  PubMed  CAS  Google Scholar 

  3. Longo UG, Loppini M, Trovato U et al (2015) No difference between unicompartmental versus total knee arthroplasty for the management of medial osteoarthtritis of the knee in the same patient: a systematic review and pooling data analysis. Br Med Bull 114:65–73. https://doi.org/10.1093/bmb/ldv009

    Article  PubMed  Google Scholar 

  4. Arirachakaran A, Choowit P, Putananon C et al (2015) Is unicompartmental knee arthroplasty (UKA) superior to total knee arthroplasty (TKA)? A systematic review and meta-analysis of randomized controlled trial. Eur J Orthop Surg Traumatol 25:799–806. https://doi.org/10.1007/s00590-015-1610-9

    Article  PubMed  Google Scholar 

  5. Aleto TJ, Berend ME, Ritter MA et al (2008) Early failure of unicompartmental knee arthroplasty leading to revision. J Arthroplasty 23:159–163. https://doi.org/10.1016/j.arth.2007.03.020

    Article  PubMed  Google Scholar 

  6. Munk S, Dalsgaard J, Bjerggaard K et al (2012) Early recovery after fast-track Oxford unicompartmental knee arthroplasty. Acta Orthop 83:41–45. https://doi.org/10.3109/17453674.2012.657578

    Article  PubMed  PubMed Central  Google Scholar 

  7. Machner A, Pap G, Awiszus F (2002) Evaluation of quadriceps strength and voluntary activation after unicompartmental arthroplasty for medial osteoarthritis of the knee. J Orthop Res 20:108–111. https://doi.org/10.1016/S0736-0266(01)00068-7

    Article  PubMed  Google Scholar 

  8. Fuchs S, Frisse D, Laass H et al (2004) Muscle strength in patients with unicompartmental arthroplasty. Am J Phys Med Rehabil 83:650–657, 662

    Article  Google Scholar 

  9. Fu YC, Simpson KJ, Kinsey TL, Mahoney OM (2013) Does interlimb knee symmetry exist after unicompartmental knee arthroplasty? Clin Orthop Relat Res 471:142–149. https://doi.org/10.1007/s11999-012-2522-1

    Article  PubMed  Google Scholar 

  10. Fu YC, Simpson KJ, Brown C et al (2014) Knee moments after unicompartmental knee arthroplasty during stair ascent knee. Clin Orthop Relat Res 472:78–85. https://doi.org/10.1007/s11999-013-3128-y

    Article  PubMed  Google Scholar 

  11. Linacre JM, Heinemann AW, Wright BD et al (1994) The structure and stability of the functional independence measure. Arch Phys Med Rehabil 75:127–132

    PubMed  CAS  Google Scholar 

  12. Marya SKS, Thukral R (2013) Outcome of unicompartmental knee arthroplasty in octogenarians with tricompartmental osteoarthritis: a longer followup of previously published report. Indian J Orthop 47:459–468. https://doi.org/10.4103/0019-5413.118201

    Article  PubMed  PubMed Central  Google Scholar 

  13. Mercier N, Wimsey S, Saragaglia D (2010) Long-term clinical results of the Oxford medial unicompartmental knee arthroplasty. Int Orthop 34:1137–1143. https://doi.org/10.1007/s00264-009-0869-z

    Article  PubMed  Google Scholar 

  14. Chung JY, Min BH (2013) Is bicompartmental knee arthroplasty more favourable to knee muscle strength and physical performance compared to total knee arthroplasty? Knee Surg Sports Traumatol Arthrosc 21:2532–2541. https://doi.org/10.1007/s00167-013-2489-9

    Article  PubMed  Google Scholar 

  15. Peixoto JG, Dias JMD, Dias RC et al (2011) Relationships between measures of muscular performance, proprioceptive acuity, and aging in elderly women with knee osteoarthritis. Arch Gerontol Geriatr 53:253–257. https://doi.org/10.1016/j.archger.2011.05.008

    Article  Google Scholar 

  16. Hartmann A, Knols R, Murer K, De Bruin ED (2009) Reproducibility of an isokinetic strength-testing protocol of the knee and ankle in older adults. Gerontology 55:259–268. https://doi.org/10.1159/000172832

    Article  PubMed  Google Scholar 

  17. Bassey EJ, Short AH (1990) A new method for measuring power output in a single leg extension: feasibility, reliability and validity. Eur J Appl Physiol Occup Physiol 60:385–390. https://doi.org/10.1007/BF00713504

    Article  PubMed  CAS  Google Scholar 

  18. Bassey EJ, Fiatarone MA, O’Neill EF et al (1992) Leg extensor power and functional performance in very old men and women. Clin Sci Lond 82:321–327

    Article  PubMed  CAS  Google Scholar 

  19. Ostchega Y, Dillon CF, Lindle R et al (2004) Isokinetic leg muscle strength in older Americans and its relationship to a standardized walk test: data from the national health and nutrition examination survey 1999–2000. J Am Geriatr Soc 52:977–982. https://doi.org/10.1111/j.1532-5415.2004.52268.x

    Article  PubMed  Google Scholar 

  20. Slemenda C, Heilman DK, Brandt KD, et al (1998) Reduced quadriceps strength relative to body weight: a risk factor for knee osteoarthritis in women? Arthritis Rheumatol 41:1951–1959. https://doi.org/10.1002/1529-0131(199811)41:11<1951::AID-ART9>3.0.CO;2-9

  21. Schmitt LC, Paterno MV, Hewett TE (2012) The impact of quadriceps femoris strength asymmetry on functional performance at return to sport following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 42:750–759. https://doi.org/10.2519/jospt.2012.4194

    Article  PubMed  PubMed Central  Google Scholar 

  22. Di Stasi SL, Logerstedt D, Gardinier ES, Snyder-Mackler L (2013) Gait patterns differ between ACL-reconstructed athletes who pass return-to-sport criteria and those who fail. Am J Sports Med 41:1310–1318. https://doi.org/10.1177/0363546513482718

    Article  PubMed  PubMed Central  Google Scholar 

  23. Ordway NR, Hand N, Briggs G, Ploutz-Snyder LL (2006) Reliability of knee and ankle strength measures in an older adult population. J Strength Cond Res 20:82. https://doi.org/10.1519/R-16974.1

    Article  PubMed  Google Scholar 

  24. Portegijs E, Sipila S, Alen M et al (2005) Leg extension power asymmetry and mobility limitation in healthy older women. Arch Phys Med Rehabil 86:1838–1842. https://doi.org/10.1016/j.apmr.2005.03.012

    Article  PubMed  Google Scholar 

  25. Skelton DA, Kennedy J, Rutherford OM (2002) Explosive power and asymmetry in leg muscle function in frequent fallers and non-fallers aged over 65. Age Ageing 31:119–125

    Article  PubMed  Google Scholar 

  26. Barker KL, Jenkins C, Pandit H, Murray D (2012) Muscle power and function 2 years after unicompartmental knee replacement. Knee 19:360–364. https://doi.org/10.1016/j.knee.2011.05.006

    Article  PubMed  Google Scholar 

  27. Cousins JM, Petit MA, Paudel ML et al (2010) Muscle power and physical activity are associated with bone strength in older men: the osteoporotic fractures in men study. Bone 47:205–211. https://doi.org/10.1016/j.bone.2010.05.003

    Article  PubMed  PubMed Central  Google Scholar 

  28. Klitgaard H, Mantoni M, Schiaffino S et al (1990) Function, morphology and protein expression of ageing skeletal muscle: a cross-sectional study of elderly men with different training backgrounds. Acta Physiol Scand 140:41–54. https://doi.org/10.1111/j.1748-1716.1990.tb08974.x

    Article  PubMed  CAS  Google Scholar 

  29. Aniansson A, Gustafsson E (1981) Physical training in elderly men with special reference to quadriceps muscle strength and morphology. Clin Physiol 1:87–98. https://doi.org/10.1111/j.1475-097X.1981.tb00876.x

    Article  Google Scholar 

  30. Startzell JK, Owens DA, Mulfinger LM, Cavanagh PR (2000) Stair negotiation in older people: a review. J Am Geriatr Soc 48:567–580

    Article  PubMed  CAS  Google Scholar 

  31. Masuda K, Kim J, Kinugasa R et al (2002) Determinants for stair climbing by elderly from muscle morphology. Percept Mot Skills 94:814–816. https://doi.org/10.2466/pms.2002.94.3.814

    Article  PubMed  Google Scholar 

  32. Tiedemann AC, Sherrington C, Lord SR (2007) Physical and psychological factors associated with stair negotiation performance in older people. J Gerontol Ser A Biol Sci Med Sci 62:1259–1265

    Article  Google Scholar 

  33. Hamel KA, Cavanagh PR (2004) Stair performance in people aged 75 and older. J Am Geriatr Soc 52:563–567. https://doi.org/10.1111/j.1532-5415.2004.52162.x

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Kinesiology, California State University, Chico, 400 West 1st St., Chico, CA, USA

    Yumeng Li

  2. Department of Physical Therapy, Ithaca College, 953 Danby Rd, Ithaca, NY, USA

    Rumit S. Kakar

  3. Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan

    Yang-Chieh Fu

  4. Athens Orthopedic Clinic, Athens, USA

    Ormonde M. Mahoney & Tracy L. Kinsey

  5. Department of Kinesiology, University of Georgia, 330 River Rd, Athens, GA, USA

    Kathy J. Simpson

Authors
  1. Yumeng Li
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  2. Rumit S. Kakar
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  4. Ormonde M. Mahoney
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  5. Tracy L. Kinsey
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  6. Kathy J. Simpson
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Correspondence to Yumeng Li.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Li, Y., Kakar, R.S., Fu, YC. et al. Knee strength, power and stair performance of the elderly 5 years after unicompartmental knee arthroplasty. Eur J Orthop Surg Traumatol 28, 1411–1416 (2018). https://doi.org/10.1007/s00590-018-2198-7

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  • DOI: https://doi.org/10.1007/s00590-018-2198-7

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