Pincheira Patricio A, De La Maza Eduardo, Silvestre Rony, Guzmán-Venegas Rodrigo, Becerra Manuel
Facultad de Ciencias, Escuela de Kinesiología, Universidad Mayor, Camino la pirámide 5750, Huechuraba, Santiago, Chile; Facultad de Medicina, Escuela de Kinesiología, Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo (LIBFE), Universidad de los Andes, Mons. Álvaro del Portillo 12455, Las Condes, Santiago, Chile; School of Human Movement and Nutrition Sciences, Centre for Sensorimotor Performance, The University of Queensland, Blair Dr, Building 26b, St Lucia, Brisbane, Australia.
Instituto Traumatológico Dr. Teodoro Gebauer, San Martín 771, Santiago Centro, Santiago, Chile.
Clin Biomech (Bristol). 2019 Feb;62:7-14. doi: 10.1016/j.clinbiomech.2018.12.024. Epub 2019 Jan 3.
The most common surgical approaches in use for total hip arthroplasty are the lateral and posterior. When comparing these approaches in terms of gait biomechanics, studies usually rely on pre-defined discrete variables related to the events of gait cycle. However, this analysis may miss differences in other parts of the movement pattern that are not explored. We applied Statistical Parametric Mapping to compare hip kinematics between patients who underwent arthroplasty using either a lateral or posterior approach, contrasting these results with discrete variable analysis.
Twenty-two participants (11 lateral, 11 posterior; age between 50 and 80 years) underwent gait analysis before, 3 weeks and 12 weeks after hip arthroplasty. One-dimensional (e.g. time-varying) trajectories and zero-dimensional (e.g. peak extension) discrete variables were used to assess differences between groups in each plane of hip movement (sagittal, frontal, and transverse).
One-dimensional and zero-dimensional analyses found no significant differences between groups. Statistical Parametric Mapping revealed that both groups presented significant changes over time in hip adduction at 11-43% of the gait cycle. Zero-dimensional analysis seems to overstate sagittal plane changes over time since no such changes were found by Statistical Parametric Mapping.
Our results agreed with previous studies suggesting that surgical approach do not affect hip kinematics at the early post-operative stage after arthroplasty. However, Statistical Parametric Mapping revealed changes in frontal plane kinematics over time that were underestimated by the zero-dimensional variables. These findings suggest hip adduction impairment up to 12 weeks after arthroplasty.
全髋关节置换术中最常用的手术入路是外侧入路和后外侧入路。在比较这些入路的步态生物力学时，研究通常依赖于与步态周期事件相关的预定义离散变量。然而，这种分析可能会忽略未探索的运动模式其他部分的差异。我们应用统计参数映射来比较采用外侧或后外侧入路进行关节置换术的患者之间的髋关节运动学，并将这些结果与离散变量分析进行对比。
22名参与者（11名采用外侧入路，11名采用后外侧入路；年龄在50至80岁之间）在髋关节置换术前、术后3周和12周接受步态分析。使用一维（如随时间变化的）轨迹和零维（如伸展峰值）离散变量来评估髋关节在每个运动平面（矢状面、额状面和横断面）上的组间差异。
一维和零维分析均未发现组间存在显著差异。统计参数映射显示，两组在步态周期的11%-43%时髋关节内收随时间均呈现显著变化。零维分析似乎夸大了矢状面随时间的变化，因为统计参数映射未发现此类变化。
我们的结果与先前的研究一致，表明手术入路在关节置换术后早期不影响髋关节运动学。然而，统计参数映射显示额状面运动学随时间的变化被零维变量低估。这些发现提示关节置换术后12周内存在髋关节内收功能障碍。
