Patients with standard total hip arthroplasties may have reduced hip abduction and extension moments when compared with normal nonosteoarthritic hips. In comparison, patients after resurfacing total hip arthroplasty appear to have a near-normal gait. The authors evaluated temporal-spatial parameters, hip kinematics, and kinetics in hip resurfacing patients compared with patients with unilateral osteoarthritic hips and unilateral standard total hip arthroplasties. Patients with resurfacing walked faster (average 1.26 m/s) and were comparable with normals. There were no significant differences in hip abductor and extensor moments of patients with resurfacing compared with patients in the standard hip arthroplasty group. This study showed more normal hip kinematics and functionality in resurfacing hip arthroplasty, which may be due to the large femoral head.
"Total hip arthroplasty (THA) is known to be an efficient way to relieve pain, provide better stability and functional capacity, and improve health-related quality of life (QOL) (Jinks et al., 2003; Jones et al., 2000; Wylde et al., 2009). Despite these postoperative improvements, patients with a THA continue to walk at a lower speed than healthy individuals 6–24 months after surgery (Mont et al., 2007; Perron et al., 2000), and the hip abductor strength in the operated leg remains reduced by 15% compared to the non-operated leg (Rasch et al., 2010). A normal walking pattern usually requires control of the medio-lateral displacement of the trunk (Dodd and Morris, 2003; Dodd et al., 1998). "
[Show abstract][Hide abstract] ABSTRACT: Background
Metal-on-metal articulations mimic the human hip anatomy, presumably lower dislocation rates and increase the range-of-motion. This study aims to measure the muscle mass and power of both legs in patients with unilateral metal-on-metal total hip arthroplasty, and to investigate their effect on block-step test, spatio-temporal gait parameters and self-reported function.
Twenty-eight patients (7 women), mean age50 (28–68) years, participated in a 5–7 year follow-up. Patients had received one type unilateral large-head metal-on-metal total hip articulation all of which were well-functioning at follow-up. Mean muscle mass was measured by total-body Dual energy X-ray Absorption scans, and muscle power was measured in a leg extensor power rig. Block-step test and spatio-temporal gait parameters were measured with an inertial measurement unit. Self-reported function was assessed by the Hip Disability and Osteoarthritis Outcome Score.
We found a significant difference between mean muscle mass of the implant-side leg and the non-implant-side leg in hip, thigh and calf areas (P < 0.008) and in mean muscle power (P = 0.025). Correlations between mean muscle mass and mean muscle power were significant for both the implant-side leg (r = 0.45, P = 0.018) and the non-implant-side leg (r = 0.51,P = 0.007). The difference in mean muscle power between legs correlated with block-step test asymmetry during ascending (r = 0.40, P = 0.047) and descending (r = 0.53, P = 0.006). Correlations between selfreported function and power of the implant-side leg were not significant.
Young patients have not fully regained muscle mass, muscle power and function 57 years after metal-on-metal total hip arthroplasty.
"Currently, objective functional mobility assessment can only be performed in a specialized laboratory, using force platforms and optical systems [17,18,27]. These laboratory measurement systems are expensive and not generally available in orthopedic practice. "
[Show abstract][Hide abstract] ABSTRACT: Total hip arthroplasty is a successful surgical treatment in patients with osteoarthritis of the hip. Different questionnaires are used by the clinicians to assess functional capacity and the patient's pain, despite these questionnaires are known to be subjective. Furthermore, many studies agree that kinematic and kinetic parameters are crucial to evaluate and to provide useful information about the patient's evolution for clinicians and rehabilitation specialists. However, these quantities can currently only be obtained in a fully equipped gait laboratory. Instrumented shoes can quantify gait velocity, kinetic, kinematic and symmetry parameters. The aim of this study was to investigate whether the instrumented shoes is a sufficiently sensitive instrument to show differences in mobility performance before and after total hip arthroplasty.
In this study, patients undergoing total hip arthroplasty were measured before and 6-8 months after total hip arthroplasty. Both measurement sessions include 2 functional mobility tasks while the subject was wearing instrumented shoes. Before each measurement the Harris Hip Score and the Traditional Western Ontario and McMaster Universities osteoarthritis index were administered as well.
The stance time and the average vertical ground reaction force measured with the instrumented shoes during walking, and their symmetry index, showed significant differences before and after total hip arthroplasty. However, the data obtained with the sit to stand test did not reveal this improvement after surgery.
Our results show that inter-limb asymmetry during a walking activity can be evaluated with the instrumented shoes before and after total hip arthroplasty in an outpatient clinical setting.
Journal of NeuroEngineering and Rehabilitation 02/2014; 11(1):20. DOI:10.1186/1743-0003-11-20 · 2.74 Impact Factor
"However, bone density appears to decrease at 6 weeks and 3 months, suggesting that caution is required until bone density recovers.28,29 Apart from minimal bone resection, additional theoretical advantages of THRS include less inflammatory debris and osteolysis, improved joint stability, and improved biomechanics.1,14 30 "
[Show abstract][Hide abstract] ABSTRACT: Improved hip kinematics and bone preservation have been reported after resurfacing total hip replacement (THRS). On the other hand, hip kinematics with standard total hip replacement (THR) is optimized with large diameter femoral heads (BFH-THR). The purpose of this study is to evaluate the functional outcomes of THRS and BFH-THR and correlate these results to bone preservation or the large femoral heads. Thirty-one patients were included in the study. Gait speed, postural balance, proprioception and overall performance. Our results demonstrated a non-statistically significant improvement in gait, postural balance and proprioception in the THRS confronting to BFH-THR group. THRS provide identical outcomes to traditional BFH-THR. The THRS choice as bone preserving procedure in younger patients is still to be evaluated.
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