Quantifying Gait Quality in Patients with Large-Head and Conventional Total Hip Arthroplasty—A Prospective Cohort Study

Jensen, Claus Hjorth; Penny, Jeannette Østergaard; Nielsen, Dennis Brandborg; Overgaard, Søren; Holsgaard-Larsen, Anders

doi:10.1016/j.arth.2015.06.049

Cited by 9 publications

(4 citation statements)

References 59 publications

(37 reference statements)

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“… 27 We found only one study supporting this hypothesis; the authors reported significantly better activities of daily living (ADL) function in patients with 32 mm heads compared with those with 26 mm heads. 16 However, clinical studies have not been able to demonstrate a statistically significant increase in hip function in terms of various patient-reported outcomes, 28 , 29 clinical outcome scores 18 and gait function 30 , 31 in bearings > 32 mm or 36 mm. It is therefore suggested that there are no functional benefits in using femoral heads > 36 mm.…”

Section: The Benefits and Drawbacks Of Large Bearingsmentioning

confidence: 99%

Head size in primary total hip arthroplasty

et al. 2018

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The use of larger femoral head size in total hip arthroplasty (THA) has increased during the past decade; 32 mm and 36 mm are the most commonly used femoral head sizes, as reported by several arthroplasty registries.The use of large femoral heads seems to be a trade-off between increased stability and decreased THA survivorship.We reviewed the literature, mainly focussing on the past 5 years, identifying benefits and complications associated with the trend of using larger femoral heads in THA.We found that there is no benefit in hip range of movement or hip function when head sizes > 36 mm are used.The risk of revision due to dislocation is lower for 36 mm or larger bearings compared with 28 mm or smaller and probably even with 32 mm.Volumetric wear and frictional torque are increased in bearings bigger than 32 mm compared with 32 mm or smaller in metal-on-cross-linked polyethylene (MoXLPE) THA, but not in ceramic-on-XLPE (CoXLPE).Long-term THA survivorship is improved for 32 mm MoXLPE bearings compared with both larger and smaller ones.We recommend a 32 mm femoral head if MoXLPE bearings are used. In hips operated on with larger bearings the use of ceramic heads on XLPE appears to be safer.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170061.

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Section: The Benefits and Drawbacks Of Large Bearingsmentioning

confidence: 99%

Head size in primary total hip arthroplasty

et al. 2018

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“…In clinical practice, hip function is commonly assessed using clinical scales such as the Hip dysfunction and Osteoarthritis Outcome Score (HOOS) [15]. However, such scales cannot offer the detailed information regarding hip function during functional activities that modern gait analysis can [16,17]. The gold standard method used for human movement analysis is stereophotogrammetry, based on 3D optical camera systems and skin markers.…”

Section: Introductionmentioning

confidence: 99%

Does the Femoral Head Size in Hip Arthroplasty Influence Lower Body Movements during Squats, Gait and Stair Walking? A Clinical Pilot Study Based on Wearable Motion Sensors

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Nilsson

Häger

et al. 2019

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A hip prosthesis design with larger femoral head size may improve functional outcomes compared to the conventional total hip arthroplasty (THA) design. Our aim was to compare the range of motion (RoM) in lower body joints during squats, gait and stair walking using a wearable movement analysis system based on inertial measurement units (IMUs) in three age-matched male groups: 6 males with a conventional THA (THAC), 9 with a large femoral head (LFH) design, and 8 hip- and knee-asymptomatic controls (CTRL). We hypothesized that the LFH design would allow a greater hip RoM, providing movement patterns more like CTRL, and a larger side difference in hip RoM in THAC when compared to LFH and controls. IMUs were attached to the pelvis, thighs and shanks during five trials of squats, gait, and stair ascending/descending performed at self-selected speed. THAC and LFH participants completed the Hip dysfunction and Osteoarthritis Outcome Score (HOOS). The results showed a larger hip RoM during squats in LFH compared to THAC. Side differences in LFH and THAC groups (operated vs. non-operated side) indicated that movement function was not fully recovered in either group, further corroborated by non-maximal mean HOOS scores (LFH: 83 ± 13, THAC: 84 ± 19 groups, vs. normal function 100). The IMU system may have the potential to enhance clinical movement evaluations as an adjunct to clinical scales.

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“…Furthermore, the selection of the parameters for the Gillette Index was specific for children with cerebral palsy, whereas the GDI is considered a general measure of the overall gait pathology or gait ‘quality’ in humans [ 14 ]. The GDI has been applied on different patient groups ranging from patients with cerebral palsy [ 15 – 18 ] to patients with hip OA [ 19 , 20 ], patients with rheumatoid arthritis [ 21 ] and patients with Parkinson’s Disease [ 22 ]. Research into associations between the GDI as a measure of gait ‘quality’ and validated clinically important outcomes will improve understanding of the clinical utility and application of the GDI in research and in the clinical context.…”

Section: Introductionmentioning

confidence: 99%

The Gait Deviation Index Is Associated with Hip Muscle Strength and Patient-Reported Outcome in Patients with Severe Hip Osteoarthritis—A Cross-Sectional Study

et al. 2016

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BackgroundThe Gait Deviation Index summarizes overall gait ‘quality’, based on kinematic data from a 3-dimensional gait analysis. However, it is unknown which clinical outcomes may affect the Gait Deviation Index in patients with primary hip osteoarthritis. The aim of this study was to investigate associations between Gait Deviation Index as a measure of gait ‘quality’ and hip muscle strength and between Gait Deviation Index and patient-reported outcomes in patients with primary hip osteoarthritis.MethodForty-seven patients (34 males), aged 61.1 ± 6.7 years, with BMI 27.3 ± 3.4 (kg/m2) and with severe primary hip osteoarthritis underwent 3-dimensional gait analysis. Mean Gait Deviation Index, pain after walking and maximal isometric hip muscle strength (flexor, extensor, and abductor) were recorded. All patients completed the ‘Physical Function Short-form of the Hip disability and Osteoarthritis Outcome Score (HOOS-Physical Function) and the Hip disability and Osteoarthritis Outcome Score subscales for pain (HOOS-Pain) and quality-of-life (HOOS-QOL).ResultsMean Gait Deviation Index was positively associated with hip abduction strength (p<0.01, r = 0.40), hip flexion strength (p = 0.01, r = 0.37), HOOS-Physical Function (p<0.01, r = 0.41) HOOS-QOL (p<0.01, r = 0.41), and negatively associated with HOOS-Pain after walking (p<0.01, r = -0.45). Adjusting the analysis for walking speed did not affect the association.ConclusionPatients with the strongest hip abductor and hip flexor muscles had the best gait ‘quality’. Furthermore, patients with higher physical function, quality of life scores and lower pain levels demonstrated better gait ‘quality’. These findings indicate that interventions aimed at improving hip muscle strength and pain management may to a moderate degree improve the overall gait ‘quality’ in patients with primary hip OA.

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Quantifying Gait Quality in Patients with Large-Head and Conventional Total Hip Arthroplasty—A Prospective Cohort Study

Cited by 9 publications

References 59 publications

Head size in primary total hip arthroplasty

Head size in primary total hip arthroplasty

Does the Femoral Head Size in Hip Arthroplasty Influence Lower Body Movements during Squats, Gait and Stair Walking? A Clinical Pilot Study Based on Wearable Motion Sensors

The Gait Deviation Index Is Associated with Hip Muscle Strength and Patient-Reported Outcome in Patients with Severe Hip Osteoarthritis—A Cross-Sectional Study

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