Simultaneous bilateral unicompartmental knee replacement improves gait parameters in patients with bilateral knee osteoarthritis

Matteo Marullo, Jacopo A. Vitale, Elena Stucovitz, Sergio Romagnoli

Research output: Contribution to journalArticlepeer-review


Background: Unicompartmental knee replacement (UKR) can provide reliable clinical and functional outcomes when performed simultaneously in both knees for treating bilateral osteoarthritis (OA). No studies to date have evaluated gait pattern after simultaneous bilateral UKR. The aim of this study was to evaluate changes in gait variables after bilateral single-stage UKR (B-UKR) and to compare them with the outcomes after unilateral UKR in two other groups of patients: one with bilateral knee OA (P-UKR) and one with the contralateral knee unaffected (H-UKR). Methods: Three-dimensional motion cohort data were prospectively collected before and six months after surgery; 37 were allocated to the B-UKR (n = 13), P-UKR (n = 12) or H-UKR (n = 12) group. Spatiotemporal variables (stride length, gait speed, gait cadence, stance phase, swing phase, and double support phase) and kinematic parameters (knee flexion and extension peak values, knee range of motion (ROM), and hip abduction peak value) were analyzed using mixed analysis of variance (ANOVA). The magnitude of effect for significant outcomes (ES) was determined using Cohen's d. Results: Postoperative improvement in gait cadence (P < 0.01; ES = 1.20), walking speed (P < 0.05; ES = 0.58), stride length (P < 0.05; ES = 0.67), knee ROM (P < 0.05; ES = 0.89), knee flexion (P < 0.05; ES = 0.94), and hip abduction (P < 0.001; ES = 1.16) was noted for the B-UKR group, whereas only stride length improved (P < 0.05; ES = 0.48) for the H-UKR group, and no changes in any gait parameter were seen for the P-UKR group. Conclusions: Postoperative improvement in gait parameters was observed in the B-UKR patients with bilateral OA. Whenever possible, simultaneous bilateral UKR should be considered in such patients.

Original languageEnglish
Pages (from-to)1413-1420
Number of pages8
Issue number6
Publication statusPublished - Jan 1 2019


  • Bilateral knee replacement
  • Gait analysis
  • Knee osteoarthritis
  • Unicompartmental knee replacement

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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