Lower limb biomechanics during gait do not return to normal following total hip arthroplasty

Beaulieu, Mélanie L.; Lamontagne, Mario; Beaulé, Paul E.

doi:10.1016/j.gaitpost.2010.05.007

Cited by 192 publications

(188 citation statements)

References 24 publications

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“…Specifically, Trudelle-Jackson et al [53] demonstrated that patients had impaired self-reported function and postural control, whereas Vissers et al [54] indicated that by 8 months after THA, patients functionally recover to only 80% of that of healthy adults. Still, other investigators indicate that gait mechanics never fully recover after THA when compared with healthy adults [2] and mechanics while climbing stairs are also impaired compared with healthy adults [27]. Although our study has characterized strength and functional performancebased outcomes during the first year after THA, we were unable to quantify the quality of movement, which may be crucial to understanding the difficulties present in these previous investigations.…”

Section: Discussionmentioning

confidence: 79%

Muscle Strength and Functional Recovery During the First Year After THA

Judd¹,

Dennis

Thomas³

et al. 2013

Clin Orthop Relat Res

135

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Background Patients undergoing total hip arthroplasty (THA) often are satisfied with the decrease in pain and improvement in function they achieve after surgery. Even so, strength and functional performance deficits persist after recovery, but these remain poorly characterized; knowledge about any ongoing strength or functional deficits may allow therapists to design rehabilitation programs to optimize recovery after THA. Questions/purposes The purposes of this study were to (1) evaluate postoperative muscle strength, function, and quality of life during the first year after THA; and (2) compare strength and function in patients 1 year after THA with a cohort of healthy peers. Methods Twenty-six patients undergoing THA were assessed 1, 3, 6, and 12 months postoperatively, and 19 adults with no hip pathology were tested as a control group. Isometric muscle strength (hip flexors, extensors, abductors, knee extensors, and flexors), functional performance (stair climbing, five times sit-to-stand, timed-up-and-go, 6-minute walk, and single-limb stance tests), and selfreported function (Hip Disability and Osteoarthritis Score, SF-36, and UCLA activity score) were compared. Results One month after THA, patients had 15% less hip flexor and extensor torque, 26% less abductor torque, 14% less knee extensor and flexor torque, and worse performance on the stair climbing, timed-up-and-go, single-limb stance, and 6-minute walk. Compared with healthy adults, patients 12 months after THA had 17% less knee extensor and 23% less knee flexor torque; however, the functional testing (including stair climbing, five times sit-to-stand, and the 6-minute walk) showed no significant differences with the patient numbers available between individuals undergoing THA and healthy control subjects. SF-36 Physical Component Scores, although significantly improved from preoperative levels, were significantly worse than healthy adults 1 year after THA (p \ 0.01).

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Section: Discussionmentioning

confidence: 79%

Muscle Strength and Functional Recovery During the First Year After THA

Judd¹,

Dennis

Thomas³

et al. 2013

Clin Orthop Relat Res

135

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“…In a recent review, THR patients were compared to that of healthy control patients 11 . It was found that in almost all studies there was reduced ROM in the hip following THR, compared to control subjects including a reduced hip abduction moment and reduced hip abduction angle 12 . It was stated that this would shift the bodyweight over the operated limb, thus reducing the muscle moment required to stabilise the pelvis.…”

Section: (2)effect Of Total Hip Replacement Surgerymentioning

confidence: 99%

Basic biomechanics of the hip

Lunn

Lampropoulos

Stewart

2016

Orthopaedics and Trauma

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(1)AbstractThe basic mechanical principles which govern how the hip joint maintains equilibrium and balance during standing and performing activities is explained along with the consequences when this balanced system is compromised. A description of the movements and forces acting around the hip joint that are expected during activities of daily living is offered and also how these movements are affected following total hip replacement, with particular reference to femoral offset and leg length inequality.

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“…The direct lateral approach has been regularly linked to post-operative Trendelenburg gait in approximately 10% of cases when walking and climbing stairs [15][16][17][18] without signs of improvement. This…”

Section: Global Functionmentioning

confidence: 99%

The influence of surgical approach on outcomes of total hip arthroplasty

Tadross¹,

Lunn²,

Redmond³

et al. 2016

Orthopaedics and Trauma

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The vast majority of total hip arthroplasties performed in the UK are undertaken using either a posterior or direct lateral approach. This review describes the functional outcomes of these approaches. Functional outcome can be assessed through motion capture of function, strength testing of muscle groups around the hip and imaging of anatomical structures. Regardless of surgical approach, total hip arthroplasty patients rarely -matched controls. The direct lateral approach is associated with abductor deficiencies whilst the posterior approach may introduce extension and rotation deficits. How long functional differences persist between surgical approaches is unclear. The emergence of improved imaging technologies as well as isokinetic dynamometry (muscle strength testing) and 3D biomechanical modelling provide more comprehensive evaluations than traditional post-operative assessments such as radiology or couch examination. Targeted physiotherapy has been suggested as a possible intervention to counter lasting functional deficits. This review provides a foundation to inform surgeons of the impact of each approach to justify their surgical practice and may inform physical rehabilitation regimens postsurgery.

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Lower limb biomechanics during gait do not return to normal following total hip arthroplasty

Cited by 192 publications

References 24 publications

Muscle Strength and Functional Recovery During the First Year After THA

Muscle Strength and Functional Recovery During the First Year After THA

Basic biomechanics of the hip

The influence of surgical approach on outcomes of total hip arthroplasty

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