Article

Gait analysis of patients with resurfacing hip arthroplasty compared with hip osteoarthritis and standard total hip arthroplasty.

Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore, Baltimore, Maryland 21215, USA.
The Journal of Arthroplasty (impact factor: 2.38). 02/2007; 22(1):100-8. DOI:10.1016/j.arth.2006.03.010 pp.100-8
Source: PubMed

ABSTRACT 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.

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    Article: Primary metal-on-metal total hip arthroplasty with large-diameter femoral heads: a clinical trial of 59 hips.
    Hakan Cicek, Kasim Kilicarslan, Nadir Yalcin, Erhan Arslan, Yunus Dogramaci, Hasan Yildirim
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    ABSTRACT: Large-diameter femoral heads with nearly anatomical sizes became available for metal-on-metal total hip arthroplasty after recent advances in metal-on-metal technology. We retrospectively studied the clinical and radiological results in 59 hips of 54 patients (32 women and 22 men, mean age 54.4 years) who underwent cementless metal-on-metal total hip arthroplasty with large-diameter heads. Patients were followed for a mean of 48.6 months. Range of motion improved significantly after surgery (p = 0.001). Harris hip scores improved from 38.5 points to 903 points at latest follow-up. We found no gender-related differences in Harris hip scores, whereas there was a correlation between age and Harris hip scores (p < 0.001), with excellent results being observed predominantly in younger patients. Mean acetabular inclination of the acetabular cup was 42.2 degrees (range: 37-51 degrees). Radiologically, a 1 mm thick radiolucency was detected in three acetabula, which were asymptomatic. One acetabulum was revised because of displacement. Three patients reported squeaking within their hips, which however disappeared in a short time. We did not observe any dislocation, deep infection or loosening. Grade 1 heterotopic ossification was detected in one hip. Although the inherent stability and the functional results of large anatomical heads are encouraging, longer follow-up data and larger series are essential to evaluate the real advantages of this type of prosthesis over conventional femoral heads.
    Acta orthopaedica Belgica 12/2010; 76(6):758-65. · 0.40 Impact Factor
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    Article: Center of Mass Compensation during Gait in Hip Arthroplasty Patients: Comparison between Large Diameter Head Total Hip Arthroplasty and Hip Resurfacing.
    Vicky Bouffard, Julie Nantel, Marc Therrien, Pascal-André Vendittoli, Martin Lavigne, François Prince
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    ABSTRACT: Objective. To compare center of mass (COM) compensation in the frontal and sagittal plane during gait in patients with large diameter head total hip arthroplasty (LDH-THA) and hip resurfacing (HR). Design. Observational study. Setting. Outpatient biomechanical laboratory. Participants. Two groups of 12 patients with LDH-THA and HR recruited from a larger randomized study and 11 healthy controls. Interventions. Not applicable. Main Outcome Measures. To compare the distance between the hip prosthetic joint center (HPJC) and the COM. The ratio (R(HPJC-COM)) and the variability (CV(HPJC-COM)) were compared between groups. Hip flexor, abductor, and adductor muscle strength was also correlated between groups while radiographic measurements were correlated with the outcome measures. Results. In the frontal plane, HR shows less variability than healthy controls at push-off and toe-off and R(HPJC-COM) is correlated with the muscle strength ratios (FR(ABD)) at heel contact, maximal weight acceptance, and mid stance. In the sagittal plane, LDH-THA has a higher R(HPJC-COM) than healthy controls at push-off, and CV(HPJC-COM) is significantly correlated with FR(FLEX). Conclusions. One year after surgery, both groups of patients, LDH-THA and HR, demonstrate minor compensations at some specific instant of the gait cycle, in both frontal and sagittal planes. However, their locomotion pattern is similar to the healthy controls.
    Rehabilitation research and practice. 01/2011; 2011:586412.
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    James W. Pritchett
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    Clinical Orthopaedics and Related Research 04/2012; 466(5):1177-1185. · 2.53 Impact Factor

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Keywords

comparable
 
extension moments
 
extensor moments
 
hip abduction
 
hip abductor
 
hip kinematics
 
hip resurfacing patients
 
large femoral head
 
near-normal gait
 
normal hip kinematics
 
normal nonosteoarthritic hips
 
patients
 
resurfacing hip arthroplasty
 
resurfacing total hip arthroplasty
 
standard hip arthroplasty group
 
standard total hip arthroplasties
 
temporal-spatial parameters
 
unilateral osteoarthritic hips
 
unilateral standard total hip arthroplasties