Wesseling Mariska, Meyer Christophe, Corten Kristoff, Desloovere Kaat, Jonkers Ilse
KU Leuven, Department of Kinesiology, Human Movement Biomechanics, Tervuursevest 101, Heverlee, Belgium.
KU Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, Leuven, Belgium.
Gait Posture. 2018 Mar;61:117-124. doi: 10.1016/j.gaitpost.2018.01.002. Epub 2018 Jan 5.
Abnormal kinematics and kinetics have been reported in hip osteoarthritis (OA) patients before and after total hip arthroplasty (THA). These changes can affect the loading of the ipsilateral hip, as well as the contralateral hip and knee joint. As it is not clear how hip and knee loading evolves in THA patients during the first year after surgery, the goal of this study is to define how joint loading changes in patients before and at three evaluation times after THA surgery. Musculoskeletal modelling in combination with gait analysis data was used to calculate hip and knee contact forces in 14 patients before and 3-, 6- and 12-months after unilateral THA, as well as in 18 healthy controls. Results showed that bilateral hip and knee loading were decreased compared to controls, both before and after THA surgery. Loading symmetry was altered compared to controls at 3-months post-surgery for the hip and at all evaluation times, except for 6-months post-surgery, for the knee, with ipsilateral joint loading decreased compared to the contralateral side. To conclude, 12-months after THA joint loading was not normalized, with both hip and knee loading in patients decreased compared to controls. Therefore, no overloading of the ipsi- or contralateral hip and knee joint was found before and up to one year after unilateral THA.
全髋关节置换术（THA）前后的髋关节骨关节炎（OA）患者已被报道存在异常的运动学和动力学变化。这些变化会影响同侧髋关节以及对侧髋关节和膝关节的负荷。由于目前尚不清楚THA患者术后第一年髋关节和膝关节的负荷是如何变化的，本研究的目的是确定THA手术前及术后三个评估时间点患者的关节负荷变化情况。结合步态分析数据的肌肉骨骼建模被用于计算14例单侧THA患者术前以及术后3个月、6个月和12个月时的髋关节和膝关节接触力，同时也计算了18名健康对照者的相应数据。结果显示，与对照组相比，THA手术前后双侧髋关节和膝关节的负荷均降低。术后3个月时髋关节以及除术后6个月外所有评估时间点的膝关节，与对照组相比负荷对称性发生改变，同侧关节负荷较对侧降低。总之，THA术后12个月关节负荷未恢复正常，患者的髋关节和膝关节负荷均低于对照组。因此，在单侧THA术前及术后长达一年的时间内，未发现同侧或对侧髋关节和膝关节存在负荷过重的情况。
