Three-dimensional gait analysis in women with a total hip arthroplasty

Perron, Martin; Malouin, Francine; Moffet, Hélène; McFadyen, Bradford J.

doi:10.1016/s0268-0033(00)00002-4

Cited by 207 publications

(201 citation statements)

References 20 publications

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“…Postoperative gait characteristics after THA have been the subject of a number of previous studies, many of which have demonstrated persistent postoperative biomechanical abnormalities at the operative hip [16][17][18]. However, there are few studies that directly compare the effect of the surgical approach on postoperative gait characteristics after THA.…”

Section: Introductionmentioning

confidence: 99%

Total Hip Arthroplasty Surgical Approach Does Not Alter Postoperative Gait Mechanics One Year After Surgery

Queen

Appleton

Butler

et al. 2013

PM&R

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Objective: To investigate the differences in gait biomechanics on the basis of surgical approach 1 year after surgery. Design: This was a descriptive laboratory study to investigate the side-to-side differences in walking mechanics at a self-selected walking speed as well as a functional assessment 1 year after total hip arthroplasty (THA). Temporospatial, kinetic, and kinematic data as well as functional outcomes were collected. Two-way analysis of variance was used to assess for between-group differences and limb-to-limb asymmetries. Setting: A controlled laboratory study. Participants: This study examined 35 patients with primary, unilateral THA. The THA surgical approaches that were used in these patients included 12 direct lateral, 18 posterior, and 11 anterolateral. All the patients were assessed 1 year after THA. Patients were excluded from the study if they had contralateral hip pain or pathology, or any prior lower extremity total joint replacements. Main Outcome Measurements: Three-dimensional lower extremity kinematics and kinetics as well as spatiotemporal variables were collected. In addition, a series of physical performance measures were collected. Results: No main effects for the physical performance measures or biomechanical variables were observed among the approach groups. Significant limb-to-limb asymmetries were observed among all the patients, with decreased sagittal plane range of motion, peak extension, and peak vertical ground reaction forces on the operative side. Conclusion:The results of this study indicated that no significant differences existed among the different surgical approach groups for any study variable. However, 1 year after THA, the patients demonstrated asymmetric gait patterns regardless of surgical approach, which indicated the potential need for continued intervention through physical therapy to regain normal side-to-side symmetry after THA.

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Section: Introductionmentioning

confidence: 99%

Total Hip Arthroplasty Surgical Approach Does Not Alter Postoperative Gait Mechanics One Year After Surgery

Queen

Appleton

Butler

et al. 2013

PM&R

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“…Studies based on selfreport data indicate that THA successfully alleviates pain and improves function relative to presurgical levels [4][5][6]. However, studies based on objective performance-based measures indicate that despite postoperative improvements, THA subjects continue to exhibit deficits in strength [7][8][9][10], postural stability [2], and gait [11].…”

Section: Introductionmentioning

confidence: 99%

Isometric performance following total hip arthroplasty and rehabilitation

Frost¹,

Bertocci²,

Wassinger³

et al. 2006

JRRD

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Abstract-We compared differences in isometric strength between older adults who have undergone elective unilateral total hip arthroplasty (THA) and completed rehabilitation with a population of community-dwelling older adults who have not had THA. The study was a cross-sectional design, and 22 unilateral THA subjects and 38 community-dwelling older adults participated. THA subjects received on average 13 outpatient or home-based physical therapy sessions before evaluation. THA subjects were evaluated 4 to 5 months postsurgery. We assessed isometric muscle strength by measuring peak hip torque per body weight with a robotic dynamometer during abduction, flexion, and extension. No significant performance differences were observed between operated and nonoperated hips of THA subjects. THA subject operated and nonoperated hips generated significantly less peak torque per body weight during flexion (p = 0.03) compared with community-dwelling older adult hips (THA subject operated hips = 6.96 ft-lb/lb, THA subject nonoperated hips = 8.26 ft-lb/lb, communitydwelling older adult hips = 11.56 ft-lb/lb). No significant differences were observed between THA subjects and community-dwelling older adults during hip extension (p = 0.55) or abduction (p = 0.17). At 4 to 5 months postsurgery, THA subjects were not at the same level of biomechanical performance as community-dwelling older adults. Significant strength deficits were found in THA subject operated versus nonoperated hips during isometric flexion. Additional or modified physical therapy that targets the hip flexors is recommended after THA.

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“…[20][21][22][23] Joint positions linked to high forces or adverse THR outcome include superior or lateral hip joint center, a small abductor moment arm, and a small offset. Theoretically, the main effect of each of these positions is to decrease the moment generating capacity of the abductors, such that they must produce a higher force to generate the same moment, thereby increasing overall implant loads.…”

mentioning

confidence: 99%

Relative importance of gait vs. joint positioning on hip contact forces after total hip replacement

Foucher

Hurwitz

Wimmer

2009

Journal Orthopaedic Research

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Implant loosening is a common indication for total hip replacement (THR) revision. High contact forces and implant twisting moments are thought to be associated with implant loosening. Relationships between joint positioning and hip forces, or outcomes, have been investigated through in vivo and in vitro modalities. Relationships between hip forces and gait are less understood, despite repeated findings that gait following a THR does not fully return to normal. We tested the hypothesis that gait parameters would be better predictors of implant force (peak contact forces and peak twisting moment during walking) than joint positioning parameters. Subjects underwent gait analysis, hip force modeling, and measurement of clinical radiographs 1 year after successful THR surgery. Gait parameters were consistently more influential in determining hip forces. Alone, gait explained as much as 67% of the variation in force, compared to a maximum of 33% by joint geometry. Combinations of gait and joint positioning parameters together explained up to 86% of the variation in hip force parameters. Results suggest that gait may provide a valuable postoperatively modifiable target to improve hip loads and potentially reduce the risk for implant loosening. ß

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Three-dimensional gait analysis in women with a total hip arthroplasty

Cited by 207 publications

References 20 publications

Total Hip Arthroplasty Surgical Approach Does Not Alter Postoperative Gait Mechanics One Year After Surgery

Total Hip Arthroplasty Surgical Approach Does Not Alter Postoperative Gait Mechanics One Year After Surgery

Isometric performance following total hip arthroplasty and rehabilitation

Relative importance of gait vs. joint positioning on hip contact forces after total hip replacement

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