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: 2.37). 02/2007; 22(1):100-8. DOI: 10.1016/j.arth.2006.03.010
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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    • "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). "
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    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. Methods 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. Findings 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. Interpretations Young patients have not fully regained muscle mass, muscle power and function 57 years after metal-on-metal total hip arthroplasty.
    Clinical Biomechanics 06/2014; 29(6). DOI:10.1016/j.clinbiomech.2014.03.007 · 1.88 Impact Factor
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    • "21 Surgery Pre and 2 mo, 1 yr post O O Loizeau et al., 1995 [86] 4 Surgery 4 yrs post O O O O Madsen et al., 2004 [38] 20 Surgery 6 mo post O O O Mont et al., 2007 [35] "
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    ABSTRACT: This chapter describes three-dimensional gait analysis and common gait deviations in adults with rheumatoid arthritis (RA) and osteoarthritis (OA). Furthermore, we describe changes in gait deviations following surgical and non-surgical interventions. Gait analysis is used to define gait deviations and to evaluate varying surgical approaches, types of surgeries and non-pharmacologic interventions. Most studies examine gait in adults with knee OA. Limitations of existing studies include small samples, poor selection of controls, sample heterogenecity, lack of baseline gait assessments and inconsistency in measurement. Across studies, time and distance parameters are generally used to provide a global measure of gait deviations. Individuals with RA and OA in the lower extremities exhibit reduced walking speed/cadence and decreased motion and moments in relation to healthy subjects. Future research should include larger sample sizes, the use of proper controls, pre- and post-assessments and identify gait abnormalities early in the disease process to minimise long-term consequences.
    Best practice & research. Clinical rheumatology 06/2012; 26(3):409-22. DOI:10.1016/j.berh.2012.05.007 · 3.06 Impact Factor
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    • "Previous studies have reported that hip abductor muscles of patients undergoing THA generate less strength compared to those of healthy subjects [6, 20– 24] and may explain the smaller hip abductor moment after THA [14] or limping during gait [5]. Furthermore, a decrease in hip abductor mechanical power [8] may also be responsible for trunk compensation [22] and abnormal gait pattern [14] in the frontal plane after THA. In the sagittal plane, a diminution in hip extension amplitude during late stance phase [25] [26], a decrease in the hip flexor and extensor moments [26] and a decrease in the work developed at the hip during push-off [8] can lead to gait impairment. "
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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 (RHPJC-COM) and the variability (CVHPJC-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 RHPJC-COM is correlated with the muscle strength ratios (FRABD) at heel contact, maximal weight acceptance, and mid stance. In the sagittal plane, LDH-THA has a higher RHPJC-COM than healthy controls at push-off, and CVHPJC-COM is significantly correlated with FRFLEX. 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.
    09/2011; 2011(2090-2867):586412. DOI:10.1155/2011/586412
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