Lower functioning patients demonstrate atypical hip joint loading before and following total hip arthroplasty for osteoarthritis

Bahl, Jasvir S.; Arnold, John B.; Taylor, Mark; Solomon, Lucian B.; Thewlis, Dominic

doi:10.1002/jor.24716

Cited by 12 publications

(7 citation statements)

References 35 publications

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“…This was combined with knowledge of the varied individual joint contact forces from gait examinations to inform tailored musculoskeletal modeling. The predicted forces were representative of a larger patient cohort 23 and are comparable to the joint contact forces reported in the literature. 40,41 While it is reasonable to speculate that improved representation of bone quality and loading conditions should improve FE estimates of bone stress and strain, further corroboration with in vivo or ex vivo experimental work will allow for further improvements in modeling.…”

Section: Discussionsupporting

confidence: 77%

“…22 Ideally, individual subject forces should be predicted using tailored musculoskeletal models. 23 Hence, the aims of our study were to: (1) develop coupled musculoskeletal-FE models for individuals who had received an uncemented acetabular component; and (2) validate the predictions of patient-specific FE models against RSA measured in vivo cup migration.…”

Section: Introductionmentioning

confidence: 99%

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Corroboration of coupled musculoskeletal model and finite element predictions with in vivo RSA migration of an uncemented acetabular component

Fallahnezhad

Callary

O’Rourke

et al. 2023

Journal Orthopaedic Research

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While finite element (FE) models have been used extensively in orthopedic studies, validation of their outcome metrics has been limited to comparison against ex vivo testing. The aim of this study was to validate FE model predictions of the initial cup mechanical environment against patient‐matched in vivo measurements of acetabular cup migration using radiostereometric analysis (RSA). Tailored musculoskeletal and FE models were developed using a combination of three‐dimensional (3D) motion capture data and clinical computerized tomography (CT) scans for a cohort of eight individuals who underwent primary total hip replacement and were prospectively enrolled in an RSA study. FE models were developed to calculate the mean modulus of cancellous bone, composite peak micromotion (CPM), composite peak strain (CPS) and percentage area of bone ingrowth. The RSA cup migration at 3 months was used to corroborate the FE output metrics. Qualitatively, all FE‐predicted metrics followed a similar rank order as the in vivo RSA 3D migration data. The two cases with the lowest predicted CPM (<20 µm), lowest CPS (<0.0041), and high bone modulus (>917 MPa) were confirmed to have the lowest in vivo RSA 3D migration (<0.14 mm). The two cases with the largest predicted CPM (>80 µm), larger CPS (>0.0119) and lowest bone modulus (<472 MPa) were confirmed to have the largest in vivo RSA 3D migration (>0.78 mm). This study enabled the first corroboration between tailored musculoskeletal and FE model predictions with in vivo RSA cup migration. Investigation of additional patient‐matched CT, gait, and RSA examinations may allow further development and validation of FE models.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Corroboration of coupled musculoskeletal model and finite element predictions with in vivo RSA migration of an uncemented acetabular component

Fallahnezhad

Callary

O’Rourke

et al. 2023

Journal Orthopaedic Research

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“…In that study, the reduction in the hip adduction moment was compensated with increased power generation in the ankle joint. However, the patients in the study of Kubota et al ( Kubota et al, 2007 ) had a very low walking speed (∼0.65 ms −1 ) so that the characteristic double peak was not visible in the hip adduction moment, which might indicate that patients with low functional status were studied ( Bahl et al, 2020 ). The patients in the present study walked at a speed similar to unilateral hip OA patients reported in various studies ( Foucher, 2017 ; Schmidt et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Gait Symmetry and Joint Moments in Unilateral and Bilateral Hip Osteoarthritis Patients and Healthy Controls

Drongelen

Braun

Stief

et al. 2021

Front. Bioeng. Biotechnol.

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Patients with unilateral hip osteoarthritis show a characteristic gait pattern in which they unload the affected leg and overload the unaffected leg. Information on the gait characteristics of patients with bilateral hip osteoarthritis is very limited. The main purposes of this study were to investigate whether the gait pattern of both legs of patients with bilateral hip osteoarthritis deviates from healthy controls and whether bilateral hip osteoarthritis patients show a more symmetrical joint load compared to unilateral hip osteoarthritis patients. In this prospective study, 26 patients with bilateral hip osteoarthritis, 26 patients with unilateral hip osteoarthritis and 26 healthy controls were included. The three groups were matched for gender, age and walking speed. Patients were scheduled for a unilateral total hip arthroplasty on the more affected/more painful side. All participants underwent a three-dimensional gait analysis. Gait kinematics and gait kinetics of patients and controls were compared using Statistical Parametric Mapping. Corrected for speed, the gait kinematics and kinetics of both legs of patients with bilateral hip osteoarthritis differed from healthy controls. Bilateral patients had symmetrical knee joint loading, in contrast to the asymmetrical knee joint loading in unilateral hip osteoarthritis patients. The ipsilateral leg of the bilateral patients could be included in studies in addition to unilateral hip osteoarthritis patients as no differences were found. Although patients with bilateral hip osteoarthritis show more symmetrical frontal plane knee joint moments, a pathological external knee adduction moment in the second half of stance was present in the ipsilateral leg in patients with unilateral and bilateral hip osteoarthritis. The lateral adjustment of the knee adduction moment may initiate or accelerate progression of degenerative changes in the lateral compartment of the knee.

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“…Therefore, ground reaction force cannot be used as a surrogate for internal hip joint loading. However, reduced gait velocity and reduced hip flexion and extension range were significantly correlated with the prevalence of a single-peak profile [ 49 ]. After THA, passive ROM in the affected hip joint showed clear improvement.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Single-Center Study of 23 Patients to Compare Gait Before and After Total Hip Arthroplasty Using the S-ROM Modular Hip System

et al. 2021

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Background This retrospective study used the Harris hip score (HHS) and range of motion (ROM) to compare gait before and after total hip arthroplasty using the modular S-ROM ® hip prosthesis in 23 patients treated at a single center. Material/Methods For this study, 23 patients with severe hip deformity, who were treated with a total hip replacement using the S-ROM ® modular hip system by DePuy ® in the period from 2003 until 2008, underwent a 3-dimensional gait analysis before and after surgery. Values were compared with a validated data set of healthy subjects. Gait analysis took place using 8 infrared cameras (50 Hz), 2 force platforms of Advanced Medical Technology, Inc. (AMTI) ® , and the Vicon ® 512 system. The HHS and ROM of the hip joint were determined preoperatively and postoperatively. The follow-up period was 16.7±15.2 months. Results A healthy gait pattern is characterized by an even stride length of both legs in relation to body height and relative symmetry of certain gait phases. These characteristics are influenced by the range of motion of the hip joint and by pelvic tilt. Symmetry could be achieved postoperatively in the stance phase and in the single-leg stance phase. However, the gait phases could not normalize. HHS and ROM improved postoperatively. Conclusions The findings from this retrospective study showed that ROM and HHS significantly improved following THA with the S-ROM ® hip prosthesis, but that gait did not completely return to normal.

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Lower functioning patients demonstrate atypical hip joint loading before and following total hip arthroplasty for osteoarthritis

Cited by 12 publications

References 35 publications

Corroboration of coupled musculoskeletal model and finite element predictions with in vivo RSA migration of an uncemented acetabular component

Corroboration of coupled musculoskeletal model and finite element predictions with in vivo RSA migration of an uncemented acetabular component

Comparison of Gait Symmetry and Joint Moments in Unilateral and Bilateral Hip Osteoarthritis Patients and Healthy Controls

A Retrospective Single-Center Study of 23 Patients to Compare Gait Before and After Total Hip Arthroplasty Using the S-ROM Modular Hip System

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