Gait and lower limb muscle strength in women after triple innominate osteotomy

Abstract

BackgroundIn adult patients with developmental hip dysplasia, a surgical procedure (triple innominate osteotomy) of the pelvic bone can be performed to rotate the acetabulum in the frontal plane, establishing better acetabular coverage. Although common clinical hip scores demonstrate significant improvements after surgery, they provide only overall information about function. The purpose of this study was to quantify the long-term outcome of triple innominate osteotomy in more detail using gait analyses and muscle strength measurements.MethodsWe performed gait analyses at self-selected walking speed as well as isometric hip and knee muscle strength tests in twelve women who had undergone a unilateral triple innominate osteotomy (age: 34 ± 12 y, time post surgery: 80 ± 18 m). We compared the results to reference values obtained from eight healthy peers (age: 33 ± 10 y).ResultsThe patients exhibited slight asymmetries in step length (smaller steps) and stance time (longer stance) as well as lower hip abduction moments in the operated limb in early stance compared to the non-operated limb. However, there were no differences in gait compared to healthy controls, even though the patients showed reduced bilateral hip abduction strength compared to controls.ConclusionsOur results indicate that the patients’ gait pattern had generally recovered very well, despite slight asymmetries in spatiotemporal parameters. Subtle deviations in hip abduction moments were observed during gait, whereas hip abduction strength was substantially reduced. Hence, the patients walked at a higher percentage of their maximal capacity. They may, therefore, be prone to fatigue and adopt compensatory gait strategies more quickly than healthy peers when walking long distances.

Gait symmetry and hip strength in women with developmental dysplasia following hip arthroplasty compared to healthy subjects: A cross-sectional study

“…Kinematic and kinetic data were captured with a three-dimensional motion capture system (Vicon MX, Oxford, United Kingdom) containing six 100 Hz digital optical cameras and two synchronized custom made force plates (AMTI, Watertown, MA, USA) embedded in the laboratory floor which measured ground reaction forces at 1000 Hz. Thirty-five retro-reflective markers were attached to each subject following the standard Vicon Plug-in-Gait marker set, excluding the head and arm markers and expanded with additional markers placed on the anterior side of the thigh and lower leg at 1/3 and 2/3 of the segment length, and on the fifth metatarsal head of the foot ( Fig 2 ) [ 18 ]. For the data analysis of the gait measurements we used Vicon Nexus software (version 1.8.4, Vicon MX, Oxford, United Kingdom), AnyBody Modeling System (AMS, version 6.0.5, AnyBody Technology A/S, Aalborg, Denmark) [ 19 ] and MATLAB (Release 2015b, The MathWorks Inc., Natick, Massachusetts, United States).…”

“…Hip abduction strength was tested in side-lying position, with the tested hip at 0° flexion and 0° adduction, and the knee extended. The non-tested hip was flexed at 45°, and the knee was flexed at 90° in order to prevent the contralateral limb from contributing to the maximum strength effort [ 18 ]. Hip extension was tested in supine position, with legs in neutral position.…”

Factors Predicting the Outcomes of Incomplete Triple Pelvic Osteotomy

“…The complications of pelvic osteotomy include major neurovascular injury (16, 19-20-21, 24), heterotopic ossification (10, 19, 24), abductor weakness (10, 25), displacement of the major trochanter (10), haematoma formation (10, 24), Sudeck atrophy (10), over- or under-correction, posterior subluxation caused by a defective posterior cover (16), and posterior colon fracture (24). Half of all patients undergoing Bernese osteotomy develop major complications (4, 11, 26, 27).…”

Sphygmomanometer test to evaluate muscle strength in individuals with lower limb amputation: validity and reliability

“…For the evaluation of hip extensors, the volunteer was placed in the ventral decubitus (VD) position and the equipment was positioned on the posterior surface of the residual limb (31). For the evaluation of the hip abductor muscles, the volunteer was lying in lateral decubitus (LD) position, with the contralateral limb kept flexed and the equipment positioned on the lateral side of the residual limb (3,32).…”