Is bicompartmental knee arthroplasty more favourable to knee muscle strength and physical performance compared to total knee arthroplasty?

摘要

Purpose: Bicompartmental knee arthroplasty features bone and ligament sparing as unicompartmental knee arthroplasty and is presumably better in the recovery of muscle strength and function compared to total knee arthroplasty (TKA) though not previously reported in the literature. The aim of the study was to compare isokinetic knee muscle strength and physical performance in patients who underwent either bicompartmental knee arthroplasty or TKA. Methods: Each of 24 patients (31 knees) was prospectively examined preoperatively, at 6 and 12 months after each surgery. Isokinetic knee extensor and flexor strength as well as position sense were measured using the Biodex system. Timed up and go test, stair climbing test, and the 6-min walk test were used to assess physical performance. The results of each group were also compared with those from the corresponding healthy control, respectively. Results: Demography showed significant difference in the mean age between bicompartment (54.8 ± 5.6 years) and TKA groups (65.7 ± 6.7 years). Comparing between the two groups, knee extensor and flexor torque, hamstring/Quadriceps ratio, position sense, and physical performance were not significantly different preoperatively, at 6 and 12 months after surgery. In intra-group analysis, muscle strength and position sense at each time point were not different in both groups. In physical performance, both groups resulted in improvement in the 6-min walk test, and only TKA group showed enhancement in stair climbing test. Conclusions: Although theoretically plausible, bicompartmental knee arthroplasty was not superior in knee muscle strength and physical performance at 1 year compared with total knee arthroplasty. Level of evidence: II.