Abstract
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.
Highlights
Total hip arthroplasty (THA) has revolutionized treatment of arthritic hip disorders when conservative management fails to relieve pain and/or restore hip function
The Hip dysfunction and Osteoarthritis Outcome Score (HOOS) profiles were lower than the reference values in both the group with a conventional prosthesis (THAC) and large femoral head (LFH) groups (LFH: 83 ± 13, THAC: 84±19 groups, vs. normal function 100; see Figure 1)
In contrast to the LFH group, the THAC had smaller hip abduction-adduction range of motion (RoM) in the operated leg compared to the non-operated leg, and instead greater knee abduction-adduction and rotation RoM in the operated leg compared to the non-operated leg. In this post-operative study, a wearable inertial measurement units (IMUs)-based movement analysis system was used to analyze whether femoral head size in hip arthroplasty influences movement patterns during squats, gait and stair walking
Summary
Total hip arthroplasty (THA) has revolutionized treatment of arthritic hip disorders when conservative management fails to relieve pain and/or restore hip function. An interesting aspect of this design was that it allowed for a larger sized femoral head. An increased femoral head size has been reported to give a better functional outcome [9,10,11,12], but contradictory reports exist [13,14]. Lu et al [10] compared two groups that had ceramic-on-ceramic prostheses with small versus large heads and showed that the large femoral head design allowed greater hip flexion RoM. Shrader et al [11] found that participants with a large femoral head design (i.e., resurfacing hip arthroplasty) achieved greater hip extension during stair walking, compared to participants with conventional THA. Petersen et al [14]
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