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The loading patterns of a short femoral stem in total hip arthroplasty: gait analysis at increasing walking speeds and inclines.

ABSTRACT: The purpose of this study was to examine the gait pattern of total hip arthroplasty (THA) patients with a new short femoral stem at different speeds and inclinations.A total of 40 unilateral THA patients were tested on an instrumented treadmill. They comprised two groups (shorter stemmed THA n?=?20, longer stemmed THA n?=?20), both which had the same surgical posterior approach. The shorter femoral stemmed patients were taken from an ongoing hip trial with minimum 12 months postop. The comparative longer THR group with similar disease and severity were taken from a gait database along with a demographically similar group of healthy controls (n?=?35). All subjects were tested through their entire range of gait speeds and inclines with ground reaction forces collected. Body weight scaling was applied and a symmetry index to compare the implanted hip to the contralateral normal hip. An analysis of variance with significance set at ??=?0.05 was used.The experimental groups were matched demographically and implant groups for patient reported outcome measures and radiological disease. Both THA groups walked slower than controls, but symmetry at all intervals for all groups were not significantly different. Push-off loading was less favourable for both the shorter and longer stemmed THR groups (p?

SUBMITTER: Wiik AV

PROVIDER: S-EPMC6097962 | biostudies-other | 2018 Aug

REPOSITORIES: biostudies-other

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The loading patterns of a short femoral stem in total hip arthroplasty: gait analysis at increasing walking speeds and inclines.

Wiik Anatole V AV Brevadt Mads M Johal Hardeep H Logishetty Kartik K Boughton Oliver O Aqil Adeel A Cobb Justin P JP

Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology 20180817 1

<h4>Background</h4>The purpose of this study was to examine the gait pattern of total hip arthroplasty (THA) patients with a new short femoral stem at different speeds and inclinations.<h4>Materials and methods</h4>A total of 40 unilateral THA patients were tested on an instrumented treadmill. They comprised two groups (shorter stemmed THA n = 20, longer stemmed THA n = 20), both which had the same surgical posterior approach. The shorter femoral stemmed patients were taken from an ongoing hip t ...[more]

PMID: 30120638

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Project description:Background and purpose - Gait analysis performed under increased physical demand may detect differences in gait between total (THA) versus resurfacing hip arthroplasty (RHA), which are not measured at normal walking speed. We hypothesized that patients after RHA would reach higher walking speeds and inclines compared with THA. Additionally, an RHA would enable a more natural gait when comparing the operated with the healthy contralateral hip. Patients and methods - From a randomized controlled trial comparing THA with RHA with at least 5 years' follow-up patients with a UCLA score of more than 3 points (n = 34) were included for an instrumented treadmill gait analysis. 25 patients with a unilateral implant (primary analysis-16 THA versus 9 RHA) and 9 patients with a bilateral implant (sub-analysis-n = 5 RHA + THA; n = 4 THA + THA). Spatiotemporal parameters, ground reaction forces, and range of motion were recorded at increasing walking speeds and inclines. Functional outcome scores were obtained. Results - At a normal walking speed of 1.1 m/s and at increasing inclines no differences were recorded in gait between the 2 groups with a unilateral hip implant. With increasing walking speed the RHA group reached a higher top walking speed (TWS) (adjusted difference 0.07 m/s, 95% CI -0.11 to 0.25) compared with THA. Additionally, RHA patients tolerated more weight on the operated side at TWS (155 N, CI 49-261) and as such weight-bearing approached the unaffected contralateral side. For the RHA group a "between leg difference" of 8 N (CI 3-245) was measured versus -129 N (CI -138 to -29) for THA (adjusted difference 144 N, CI 20-261). Hip flexion of the operated side at TWS was higher after RHA compared with THA (adjusted difference 8°, CI 1.7-14). Interpretation - In this study RHA patients reached a higher walking speed, and preserved a more normal weight acceptance and a greater range of hip flexion against their contralateral healthy leg as compared with patients with a THA.

Dataset Information

The loading patterns of a short femoral stem in total hip arthroplasty: gait analysis at increasing walking speeds and inclines.

Publications

The loading patterns of a short femoral stem in total hip arthroplasty: gait analysis at increasing walking speeds and inclines.

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