Jäckle Katharina, Walde Tim Alexander, Meier Marc-Pascal, Hawellek Thelonius, Roch Paul-Jonathan, Homann Colja, Castro William H M, Wagner Heiko, Boström Kim, Lehmann Wolfgang, Weiser Lukas
Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075, Göttingen, Germany.
ArthroVeris-Göttingen, Groner-Tor-Straße 3, 37073, Göttingen, Germany.
J Orthop. 2025 Mar 20;70:54-62. doi: 10.1016/j.jor.2025.03.028. eCollection 2025 Dec.
Total hip arthroplasty, a common surgical procedure in orthopedics, is used in patients with severe hip osteoarthritis to relieve pain and to restore the function. The surgery has been shown to be effective, but patients may experience gait limitations after surgery. We used a novel and innovative tool, Computed MyoGraphy (CMG), to analyse the gait kinematics and forces acting within the musculoskeletal system after total hip arthroplasty. Data obtained at different time points before and after surgery were compared with those of healthy subjects.
The gait patterns of patients with primary hip osteoarthritis patients and healthy subjects were compared using the Xsens Awinda system in combination with the CMG system. Joint contact forces and shear joint contact forces were assessed preoperatively at the 5th postoperative day as well as after the rehabilitation examining two types of movements, "walking" and "squatting".
As revealed by CMG during both, normal walking and in particular during squatting, pre- and postoperative patients showed lower values for total and shear hip joint contact forces on both sides of the body when compared to healthy subjects. These initial differences in the total and shear joint contact forces at the hip vanished after the completion of the rehabilitation process.
Total hip arthroplasty patients are initially limited to squat and walk normally, as they exert lower total and shear hip joint contact forces, interestingly not only on the affected side but also on the contralateral side. Rehabilitation improves the force development to a degree similar to healthy patients. CMG provides clinical usability that objectifies gait analyses and provide useful additional functional information for clinical practice.
Prospective study of gait analysis after primary total hip arthroplasty measured by Computed MyoGraphy (CMG) using Myonardo, DRKS00028175. Registered February 16, 2022 - Prospectively registered. Trial registration number DRKS00028175.
全髋关节置换术是骨科常见的外科手术，用于治疗重度髋骨关节炎患者以缓解疼痛并恢复功能。该手术已被证明有效，但患者术后可能会出现步态受限。我们使用了一种新颖且创新的工具——计算机肌电图（CMG），来分析全髋关节置换术后肌肉骨骼系统内的步态运动学和作用力。将手术前后不同时间点获得的数据与健康受试者的数据进行比较。
使用Xsens Awinda系统结合CMG系统比较原发性髋骨关节炎患者和健康受试者的步态模式。在术前、术后第5天以及康复后，对“行走”和“下蹲”两种运动类型评估关节接触力和剪切关节接触力。
CMG显示，在正常行走尤其是下蹲过程中，与健康受试者相比，术前和术后患者身体两侧的总髋关节接触力和剪切髋关节接触力值均较低。康复过程完成后，髋关节总接触力和剪切接触力的这些初始差异消失。
全髋关节置换术患者最初在蹲和正常行走方面受到限制，因为他们施加的髋关节总接触力和剪切接触力较低，有趣的是，不仅在患侧，对侧也是如此。康复可将力量发展改善到与健康患者相似的程度。CMG提供了临床实用性，可客观化步态分析并为临床实践提供有用的额外功能信息。
使用Myonardo通过计算机肌电图（CMG）对初次全髋关节置换术后步态分析进行的前瞻性研究，DRKS00028175。2022年2月16日注册——前瞻性注册。试验注册号DRKS00028175。
