Abstract
Objective. To compare center of mass (COM) compensation in the frontal and sagittal plane during gait in patients with large diameter head total hip arthroplasty (LDH-THA) and hip resurfacing (HR). Design. Observational study. Setting. Outpatient biomechanical laboratory. Participants. Two groups of 12 patients with LDH-THA and HR recruited from a larger randomized study and 11 healthy controls. Interventions. Not applicable. Main Outcome Measures. To compare the distance between the hip prosthetic joint center (HPJC) and the COM. The ratio (RHPJC-COM) and the variability (CVHPJC-COM) were compared between groups. Hip flexor, abductor, and adductor muscle strength was also correlated between groups while radiographic measurements were correlated with the outcome measures. Results. In the frontal plane, HR shows less variability than healthy controls at push-off and toe-off and RHPJC-COM is correlated with the muscle strength ratios (FRABD) at heel contact, maximal weight acceptance, and mid stance. In the sagittal plane, LDH-THA has a higher RHPJC-COM than healthy controls at push-off, and CVHPJC-COM is significantly correlated with FRFLEX. Conclusions. One year after surgery, both groups of patients, LDH-THA and HR, demonstrate minor compensations at some specific instant of the gait cycle, in both frontal and sagittal planes. However, their locomotion pattern is similar to the healthy controls.
Highlights
Hip arthroplasty has become a standard procedure [1,2,3] to improve quality of life [4], restore physical capacities, relieve patients from pain [5, 6], and provide better hip function [5, 7] and stability [8]
large diameter head total hip arthroplasty (LDH-total hip arthroplasty (THA)) has a higher RHPJC-center of mass (COM) than healthy controls at push-off, and CVHPJC-COM is significantly correlated with FRFLEX
LDH-THA and hip resurfacing (HR) patients of this study showed a higher cadence compared to healthy controls while LDH-THA patients walked with a greater velocity when compared to healthy controls
Summary
Hip arthroplasty has become a standard procedure [1,2,3] to improve quality of life [4], restore physical capacities, relieve patients from pain [5, 6], and provide better hip function [5, 7] and stability [8]. As for HR technique, the femoral head and acetabulum are shaped and covered with implants, using a large diameter femoral head size. This technique preserved more bone and became advantageous [13] (Figure 1(b)). A variation of THA has been used with a large diameter femoral head (LDH-THA) leaving the presence of a femoral stem the only anatomical difference between the two types of prosthesis (Figure 1(c)). Both types of implants, LDH-THA and HR, Rehabilitation Research and Practice (a)
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