Cane-assisted gait biomechanics and electromyography after total hip arthroplasty

Abstract

Ajemian S, Thon D, Clare P, Kaul L, Zernicke RF, Loitz-Ramage B. Cane-assisted gait biomechanics and electromyography after total hip arthroplasty. Objective To quantify the effects of cane use during walking on hip joint kinematics, kinetics, and muscle activity patterns after unilateral total hip arthroplasty (THA). Design Nonrandomized experimental design. Setting Urban inpatient hospital. Participants Adults (n=9 men, 2 women) with no history of orthopedic or neuromuscular disease who underwent elective unilateral THA. Intervention Gait was assessed preoperatively and 4 and 8 months postoperatively. Main outcome measures Three-dimensional hip joint motion and moments and electromyographic patterns of gluteus medius, tensor fascia latae, lateral hamstring, and vastus lateralis were measured during level walking, with and without use of a straight cane. Results When a cane was held in the contralateral hand, the abduction moment of the affected hip decreased by 26%, whereas that of the contralateral hip increased by 28%. Use of a cane in THA rehabilitation is important because it reduces the load on the operative hip so that bone and soft tissues can heal. Our results suggest that load reduction was successful on the operative side, but the loads on the contralateral side were increased. Conclusions After unilateral arthroplasty, subjects using a cane had increased hip abduction moments on the nonoperative hip and decreased hip abduction moments on the operative hip. Clinicians should be mindful of the effects of cane use on the contralateral hip.