Unilateral total hip replacement patients with symptomatic leg length inequality have abnormal hip biomechanics during walking (original) (raw)
Related papers
2016
Up to 10% of patients following Total Hip Replacement (THR) are symptomatic for a Leg Length Inequality (LLI), commonly being up to 20mm longer on the operated side. With 100,000 patients undergoing THR in 2015, 8.7% of all errors in the NHS being attributed to an LLI and malpractice claims being frequent, understanding why certain patients are symptomatic whilst others remain asymptomatic is of great importance. Anthropometric and demographic measurements together with gait analysis results were compared between a group of 26 symptomatic LLI patients following THR, 14 asymptomatic THR patients and 38 healthy individuals using Plug-in-Gait. Statistically significant results were found for height, with LLI patients generally being 6% shorter than their THR counterparts. Gait analysis results using Visual3D and AnyBody found LLI patients demonstrated reductions in peak joint forces, ground reaction forces, moments and knee flexion relative to the THR and healthy group. This was linked...
Gait & posture, 2016
We aimed to investigate the relationship between postoperative leg length/offset (LL/OS) reconstruction and gait performance after total hip arthroplasty (THA). In the course of a prospective randomized controlled trial, 60 patients with unilateral hip arthrosis received cementless THA through a minimally-invasive anterolateral surgical approach. One year post-operatively, LL and global OS restoration were analyzed and compared to the contralateral hip on AP pelvic radiographs. The combined postoperative limb length/OS reconstruction of the operated hip was categorized as restored (within 5mm) or non-restored (more than 5mm reduction or more than 5mm increment). The acetabular component inclination, anteversion and femoral component anteversion were evaluated using CT scans of the pelvis and the femur. 3D gait analysis of the lower extremity and patient related outcome measures (HHS, HOOS, EQ-5D) were obtained pre-operatively, six months and twelve months post-operatively by an obse...
Gait Analysis after Unilateral Total Hip Replacement Surgery
Al-Nahrain Journal for Engineering Sciences
Total hip replacement (THR) is an elective surgical procedure with the primary indication being pain relief. The aim of this study is to analyze gait dynamics for patients after they underwent a unilateral THR surgery and compare it with normal parameters. To investigate the gait dynamics a gait analysis was performed on five patients after they underwent a unilateral THR surgery; only two of them were examined before the surgery. The gait analysis was performed using a digital video camera with two force plates. Kinematics data were obtained from 2D trajectories of seven passive markers using SkillSpector software. MATLAB software has been used for inverse dynamics computation. General gait parameters, Harris Hip Score, joints’ angles, forces, moments and powers were obtained during gait cycle. It was found that the average of improvement in Harris Hip Score (for four patients who were examined 1.5, 2.5, 3 and 9 months after surgery) is 61.8 points, which is an indication of pain r...
Prevalence and functional impact of patient-perceived leg length discrepancy after hip replacement
International Orthopaedics, 2009
The aim of this survey was to determine the prevalence of patient-perceived leg length discrepancy (LLD) after primary total hip replacement (THR) and its impact on functional outcome. All consecutive patients who had a primary, unilateral THR at one orthopaedic centre between April 1993-1996 were sent a questionnaire which included the Oxford hip score (OHS) and questions about LLD. A total of 1,114 patients returned completed questionnaires. Three hundred and twenty nine patients (30%) reported a LLD. Of these patients, 161 patients (49%) were bothered by the difference, 101 patients (31%) used a shoe raise and 13 patients (4%) thought that the surgery had not been worthwhile. Patients with a LLD had a significantly poorer OHS (p<0.001) and limped more frequently. This study found that a third of patients perceived a LLD at 5-8 years after THR and LLD had a significant negative impact on functional outcome.
The importance of leg length discrepancy after total hip arthroplasty
Journal of Bone and Joint Surgery - British Volume, 2005
We assessed leg length discrepancy and hip function in 90 patients undergoing primary total hip arthroplasty before surgery and at three and 12 months after. Function was measured using the Oxford hip score (OHS). After surgery the mean OHS improved by 26 points after three months and by 30 points after 12.
Hip joint load in relation to leg length discrepancy
Medical Devices: Evidence and Research, 2008
Leg length discrepancy is common both in healthy subjects and after total hip arthroplasty (THA). Studies that evaluated leg length following THA have demonstrated a notable inconsistency in restoring leg length. The effects concerning joint load during gait is however not well known. The purpose of this study was to use three-dimensional (3D) gait analysis to evaluate joint load during gait with a simulated leg length discrepancy of 2 and 4 cm. Nine healthy subjects without any history of hip injury participated. Method: A 3D gait analysis (Vicon, Motion System, Oxford, England) was performed with 6 cameras and 2 force palates using a standard biomechanical gait model. Hip joint moments of force were calculated for all three degrees of motion freedom. ANOVA for repeated measurements was used for statistical calculations. Results: Abduction peak moment was signifi cantly increased at the short side (P Ͻ 0.05) but unaffected on the long side. The adduction moment decreased on the long side between 0 and 4 cm (P Ͻ 0.01) but was unaffected on the short side. The internal hip rotation moments were unchanged for both the long and the short side. The external rotation moment was unchanged on the short side and decreased between bare foot and 4 cm on the long side (P Ͻ 0.05). Conclusion: A leg length discrepancy of 2 cm or more creates biomechanical changes concerning hip joint load both on the long and the short side and that the effects are larger on the short side. The increased stress may cause problems in the long run.
Gait and functionality following unilateral and bilateral hip replacement
Fisioterapia em Movimento, 2019
Introduction: Total Hip Replacement (THR) is a surgical procedure used to minimize symptoms generated by orthopedic pathologies, such as osteoarthritis. It is emphasized that there is no agreement if gait parameters are restored after surgery. Objective: To compare gait space-time and functionality between individuals submitted to unilateral or bilateral THR in relation to healthy controls. Method: A cross-sectional study was conducted with 23 subjects, eight submitted to Bilateral THR (BG), eight submitted to Unilateral THR (UG) and seven healthy individuals (CG). For the gait analysis, the 10-meter walk test was used, with the subjects walking in their Habitual (HS) and Maximal (MS) gait Speeds. Variables of interest included average speed, number of steps, test duration, cadence and Inter-Stride Time Variability (ISTV). Functionality was assessed by the Harris Hip Score and the WOMAC questionnaire. Comparisons were made between the three groups. Results: At the HS condition, the ...
Assessment of gait after bilateral hip replacement. Case study
Ortopedia, traumatologia, rehabilitacja, 2014
Endoprotezoplastyka (THA) jest jedną z najskuteczniejszych metod leczenia zaawansowanej artrozy biodra (HOA). W wielu przypadkach, pomimo prawidłowo przeprowadzonego zabiegu operacyjnego, wciąż pozostają utrwalone patologiczne wzorce chodu, które zaburzają prawidłowe właściwości ścierne powierzchni sztucznego stawu. Celem badań była ocena funkcjonalna i biomechaniczna chodu osoby po obustronnej THA spowodowanej zaawansowanymi zmianami zwyrodnieniowymi stawu biodrowego, pod kątem wyróżnienia parametrów chodu, które istotnie odbiegają od wzorca chodu prawidłowego na różnych etapach leczenia.