Gait biomechanics after total hip arthroplasty: using statistical parametric mapping to identify differences between various surgical approaches
Conference: 20th EFORT Congress in Lisbon, Portugal
Abstract: Biomechanical studies have tried to assess the impact of the surgical approach on gait characteristics and recovery after total hip arthroplasty (THA). Some studies which used discrete analyses have shown that some surgical approaches provide better hip joint function after one year post-surgery, but several studies did not find any differences. The goal of this study was to compare hip biomechanics during gait using statistical parametric mapping (SPM) in patients who underwent THA with either a lateral (LAT), anterior (ANT), or posterior (POS) approach. Forty-five patients underwent unilateral THA with either a LAT, ANT, or approach, and were compared with 15 healthy controls (CTRL). All patients underwent biomechanical gait analysis approximately 9 months following surgery. Hip biomechanics were compared between groups throughout the entire gait cycle using a One-Way ANOVA SPM. Alpha was set to 0.05 and Bonferroni post hoc comparisons were completed. The POS group had a significantly lower hip flexion moment just prior to toe-off compared to the ANT and CTRL groups. The ANT group had significantly lower hip abduction moment for most of the stance phase compared to the LAT and CTRL groups. The POS group had a significantly lower hip abduction moment compared to the LAT and CTRL groups. These findings tend to contradict existing literature. Future studies should complete both pre- and post-operative assessments with a larger cohort in each group, as well as standardize the implants as much as possible to determine if observed differences are due to the approach and no other factors.
Listed In: Biomechanics, Orthopedic Research,
Tagged In: gait, kinematics, kinetics, total hip arthroplasty
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Abstract: Biomechanical studies have tried to assess the impact of the surgical approach on gait characteristics and recovery after total hip arthroplasty (THA). Some studies which used discrete analyses have shown that some surgical approaches provide better hip joint function after one year post-surgery, but several studies did not find any differences. The goal of this study was to compare hip biomechanics during gait using statistical parametric mapping (SPM) in patients who underwent THA with either a lateral (LAT), anterior (ANT), or posterior (POS) approach. Forty-five patients underwent unilateral THA with either a LAT, ANT, or approach, and were compared with 15 healthy controls (CTRL). All patients underwent biomechanical gait analysis approximately 9 months following surgery. Hip biomechanics were compared between groups throughout the entire gait cycle using a One-Way ANOVA SPM. Alpha was set to 0.05 and Bonferroni post hoc comparisons were completed. The POS group had a significantly lower hip flexion moment just prior to toe-off compared to the ANT and CTRL groups. The ANT group had significantly lower hip abduction moment for most of the stance phase compared to the LAT and CTRL groups. The POS group had a significantly lower hip abduction moment compared to the LAT and CTRL groups. These findings tend to contradict existing literature. Future studies should complete both pre- and post-operative assessments with a larger cohort in each group, as well as standardize the implants as much as possible to determine if observed differences are due to the approach and no other factors.
Listed In: Biomechanics, Orthopedic Research,
Tagged In: gait, kinematics, kinetics, total hip arthroplasty
View PDF | Contact Author