Human Movement Biomechanics Laboratory, University of Ottawa, Ottawa, Ontario, Canada.
Human Movement Biomechanics Laboratory, University of Ottawa, Ottawa, Ontario, Canada; Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada.
J Arthroplasty. 2024 Feb;39(2):402-408.e1. doi: 10.1016/j.arth.2023.08.040. Epub 2023 Aug 18.
This study aimed to examine how hip offset (HO) and surgical approach affect gait biomechanics following total hip arthroplasty (THA).
There were 55 THA patients assigned to 3 groups based on surgical approach (ANT: anterior, LAT: lateral, or POS: posterior) and HO difference (large HO: >5 millimeters (mm), small HO; <5 mm, or normal; between +3 mm and -3 mm). Kinematics and kinetics were recorded using motion capture and force plate data. Group differences were assessed using statistical parametric mapping.
The ANT group demonstrated more normal sagittal plane kinematics and kinetics. No frontal plane kinematic differences were found, but the LAT group displayed more normal frontal plane kinetics. The LAT group displayed a slower walking speed than the ANT group, and the LAT and POS groups used a shorter stride/step length than the control group. The large HO group showed fewer differences in sagittal plane kinematics and kinetics than the small HO and normal groups. No frontal plane kinematic differences were observed, but the normal group demonstrated more significant differences than the large HO and small HO groups. No significant differences were found between any of the HO patient groups.
Anterior and lateral approaches led to more normal gait biomechanics in sagittal kinematics and frontal kinetics, respectively, but only the ANT group exhibited spatiotemporal gait parameters within normal ranges. Hip offset differences greater or less than 5 mm do not significantly change gait patterns. Surgical approach plays a greater role than HO reconstruction in producing more normal gait biomechanics following THA.
本研究旨在探讨髋关节外展（HO）和手术入路对全髋关节置换术（THA）后步态生物力学的影响。
根据手术入路（ANT：前侧，LAT：外侧，POS：后侧）和 HO 差值（大 HO：>5 毫米（mm），小 HO：<5 mm，或正常：+3 毫米和-3 毫米之间），将 55 例 THA 患者分为 3 组。使用运动捕捉和力板数据记录运动学和动力学。使用统计参数映射评估组间差异。
ANT 组表现出更正常的矢状面运动学和动力学。未发现额状面运动学差异，但 LAT 组表现出更正常的额状面动力学。LAT 组的行走速度比 ANT 组慢，LAT 和 POS 组的步长/步长比对照组短。大 HO 组在矢状面运动学和动力学方面的差异比小 HO 和正常组小。未观察到额状面运动学差异，但正常组比大 HO 和小 HO 组表现出更大的差异。在任何 HO 患者组之间均未发现显著差异。
前侧和外侧入路分别导致矢状面运动学和额状面动力学更正常的步态生物力学，但只有 ANT 组表现出正常范围内的时空步态参数。HO 差值大于或小于 5 毫米不会显著改变步态模式。手术入路在产生更正常的 THA 后步态生物力学方面的作用大于 HO 重建。
