Loppini Mattia, Temporiti Federico, Furone Roberta, Galli Manuela, Grappiolo Guido, Gatti Roberto
Hip and Knee Orthopaedic Surgery Department, Humanitas Clinical and Research Centre, Milan, Italy.
Humanitas University, Milan, Italy.
Hip Int. 2021 Nov;31(6):729-734. doi: 10.1177/1120700020921120. Epub 2020 May 4.
The pelvis rotates simultaneously around both hips along sagittal, frontal and transversal planes and its kinematics change in patients after total hip arthroplasty (THA). Consequently, it is reasonable to expect different pelvic kinematic profiles in bilateral or unilateral THA. Therefore, the aim of this study was to compare pelvic kinematics in patients with bilateral or unilateral THA.
40 patients undergoing bilateral ( 20) or unilateral ( 20) THA were evaluated for pelvic kinematics during standing and walking tasks using an optoelectronic system. Mean pelvic orientation was assessed during standing, whereas the Gait Variable Score (GVS), maximum and minimum peaks, range and values of pelvic tilt, obliquity and rotation during Heel-Strike and Toe-Off phases of gait cycle were calculated during walking. Data were collected the day before and at seven days after surgery.
At baseline, no between-group differences were found. At 7 days, GVS for pelvic tilt ( 0.029) and rotation ( 0.046) were closer to normative data in bilateral patients, who also revealed lower maximum peak of anterior tilt ( 0.013) and lower range of pelvic tilt during gait ( 0.031) with respect to unilateral cases. No between-group differences were found for pelvic orientation during standing at any time-point.
Bilateral patients revealed more physiological pelvic kinematics than unilateral cases. These findings underline the advantage of patients undergoing 1-stage bilateral THA and may be helpful in selecting personalised rehabilitative approaches.
骨盆同时围绕双髋关节在矢状面、额状面和横断面旋转,全髋关节置换术(THA)后患者的骨盆运动学发生改变。因此,双侧或单侧THA患者的骨盆运动学特征可能不同是合理的预期。所以,本研究的目的是比较双侧或单侧THA患者的骨盆运动学。
使用光电系统对40例行双侧(20例)或单侧(20例)THA的患者在站立和行走任务期间的骨盆运动学进行评估。站立时评估骨盆平均方位,而在行走时计算步态周期中足跟触地和足趾离地阶段骨盆倾斜、倾斜度和旋转的步态变量评分(GVS)、最大和最小峰值、范围和值。在手术前一天和术后七天收集数据。
基线时,未发现组间差异。在术后7天,双侧患者骨盆倾斜(0.029)和旋转(0.046)的GVS更接近正常数据,相对于单侧病例,双侧患者还显示出较低的前倾最大峰值(0.013)和步态期间较低的骨盆倾斜范围(0.031)。在任何时间点站立时,骨盆方位均未发现组间差异。
双侧患者的骨盆运动学比单侧患者更接近生理状态。这些发现强调了一期双侧THA患者的优势,可能有助于选择个性化的康复方法。