Vol. 7, Issue 2, Part A (2025)

Background: Unilateral hip and knee osteoarthritis (OA) significantly impacts joint biomechanics, leading to asymmetrical gait patterns, altered load distribution, and compensatory mechanisms in the contralateral limb. While both conservative and surgical treatments aim to restore function, their respective biomechanical outcomes remain variably described in the literature.
Objective: To systematically review and synthesize evidence regarding biomechanical alterations in individuals with unilateral hip or knee OA undergoing conservative or surgical treatment, with a specific focus on gait symmetry, joint loading redistribution, and compensatory adaptations.
Methods: A systematic search was conducted in PubMed, Scopus, and Web of Science for studies published between January 2013 and December 2024. Sixty-seven studies met the inclusion criteria. Data were extracted and categorized by treatment modality, joint affected, and biomechanical focus. Comparative and integrative analyses were performed, including evaluation of gait variables, finite element modeling outcomes, and functional performance measures.
Results: Surgical treatments, particularly Total Hip Arthroplasty (THA), were consistently associated with substantial improvements in joint kinetics, gait normalization, and symmetrical load distribution. Total Knee Arthroplasty (TKA) showed more variable outcomes, largely influenced by implant design and surgical execution. Conservative approaches, including physical therapy and gait retraining, provided moderate biomechanical improvements in early-stage OA but demonstrated limited efficacy in structural correction. Computational modeling reinforced clinical findings, revealing reduced stress concentrations and enhanced implant behavior with optimized surgical strategies.
Conclusion: Surgical intervention offers the most robust biomechanical benefits in unilateral OA, particularly in advanced stages. Conservative management remains essential for early intervention and functional support. An integrated, patient-specific strategy combining surgical precision, rehabilitation, and biomechanical modeling is crucial to achieving optimal outcomes and preventing contralateral overload.