Are changes in radiological leg alignment and femoral parameters after total hip replacement responsible for joint loading during gait?
Abstract Background Gait kinematics after total hip replacement only partly explain the differences in the joint moments in the frontal plane between hip osteoarthritis patients after hip replacement and healthy controls. The goal of this study was to determine if total hip replacement surgery affec...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-019-2832-5 |
| _version_ | 1818436934062571520 |
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| author | Stefan van Drongelen Hanna Kaldowski Timur Tarhan Ayman Assi Andrea Meurer Felix Stief |
| author_facet | Stefan van Drongelen Hanna Kaldowski Timur Tarhan Ayman Assi Andrea Meurer Felix Stief |
| author_sort | Stefan van Drongelen |
| collection | DOAJ |
| description | Abstract Background Gait kinematics after total hip replacement only partly explain the differences in the joint moments in the frontal plane between hip osteoarthritis patients after hip replacement and healthy controls. The goal of this study was to determine if total hip replacement surgery affects radiological leg alignment (Hip-Knee-Shaft-Angle, femoral offset, Neck-Shaft-Angle and varus/valgus alignment) and which of these parameters can explain the joint moments, additionally to the gait kinematics. Methods 22 unilateral hip osteoarthritis patients who were scheduled for total hip replacement were included in the study. Preoperatively and 1 year postoperatively all patients had biplanar radiographic examinations and 3D gait analysis. Results The operated leg showed significantly (P < 0.05) more varus (1.1°) as well as a larger femoral offset (+ 8 mm) and a larger Hip-Knee-Shaft-Angle (+ 1.3°) after total hip replacement; however no significant differences in the joint moments in the frontal plane compared to healthy controls were found. The hip moment (first half of stance) and the knee moments (first and second half of stance) were mostly determined by the varus/valgus alignment (29% and respectively 36% and 35%). The combination with a kinematic parameter (knee range of motion, foot progression angle) increased the predictive value for the knee moments. Conclusion In our patient group the joint moments after total hip replacement did not differ from healthy controls, whereas radiological leg alignment parameters changed significantly after the total hip replacement. A combination of these radiological leg parameters, especially the varus alignment, and the deviating kinematics explain the joint moments in the frontal plane during gait after total hip replacement surgery. For surgeons it is important not to create too much of a structural varus alignment by implanting the new hip joint as varus alignment can increase the knee adduction moment and the risk for osteoarthritis of the medial knee compartment. Trial registration This study was retrospectively registered with DRKS (German Clinical Trials Register) under the number DRKS00015053. Registered 1st of August 2018. |
| first_indexed | 2024-12-14T17:16:40Z |
| format | Article |
| id | doaj.art-806c8d58f4b1400ca6c9455b63387cd7 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-14T17:16:40Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-806c8d58f4b1400ca6c9455b63387cd72022-12-21T22:53:24ZengBMCBMC Musculoskeletal Disorders1471-24742019-11-0120111310.1186/s12891-019-2832-5Are changes in radiological leg alignment and femoral parameters after total hip replacement responsible for joint loading during gait?Stefan van Drongelen0Hanna Kaldowski1Timur Tarhan2Ayman Assi3Andrea Meurer4Felix Stief5Orthopaedic University Hospital Friedrichsheim gGmbH, Dr. Rolf M. Schwiete Research Unit for OsteoarthritisOrthopaedic University Hospital Friedrichsheim gGmbHOrthopaedic University Hospital Friedrichsheim gGmbHLaboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-JosephOrthopaedic University Hospital Friedrichsheim gGmbHOrthopaedic University Hospital Friedrichsheim gGmbHAbstract Background Gait kinematics after total hip replacement only partly explain the differences in the joint moments in the frontal plane between hip osteoarthritis patients after hip replacement and healthy controls. The goal of this study was to determine if total hip replacement surgery affects radiological leg alignment (Hip-Knee-Shaft-Angle, femoral offset, Neck-Shaft-Angle and varus/valgus alignment) and which of these parameters can explain the joint moments, additionally to the gait kinematics. Methods 22 unilateral hip osteoarthritis patients who were scheduled for total hip replacement were included in the study. Preoperatively and 1 year postoperatively all patients had biplanar radiographic examinations and 3D gait analysis. Results The operated leg showed significantly (P < 0.05) more varus (1.1°) as well as a larger femoral offset (+ 8 mm) and a larger Hip-Knee-Shaft-Angle (+ 1.3°) after total hip replacement; however no significant differences in the joint moments in the frontal plane compared to healthy controls were found. The hip moment (first half of stance) and the knee moments (first and second half of stance) were mostly determined by the varus/valgus alignment (29% and respectively 36% and 35%). The combination with a kinematic parameter (knee range of motion, foot progression angle) increased the predictive value for the knee moments. Conclusion In our patient group the joint moments after total hip replacement did not differ from healthy controls, whereas radiological leg alignment parameters changed significantly after the total hip replacement. A combination of these radiological leg parameters, especially the varus alignment, and the deviating kinematics explain the joint moments in the frontal plane during gait after total hip replacement surgery. For surgeons it is important not to create too much of a structural varus alignment by implanting the new hip joint as varus alignment can increase the knee adduction moment and the risk for osteoarthritis of the medial knee compartment. Trial registration This study was retrospectively registered with DRKS (German Clinical Trials Register) under the number DRKS00015053. Registered 1st of August 2018.http://link.springer.com/article/10.1186/s12891-019-2832-5Total hip replacementLeg alignmentUnilateral hip osteoarthritisGait analysisJoint loading |
| spellingShingle | Stefan van Drongelen Hanna Kaldowski Timur Tarhan Ayman Assi Andrea Meurer Felix Stief Are changes in radiological leg alignment and femoral parameters after total hip replacement responsible for joint loading during gait? BMC Musculoskeletal Disorders Total hip replacement Leg alignment Unilateral hip osteoarthritis Gait analysis Joint loading |
| title | Are changes in radiological leg alignment and femoral parameters after total hip replacement responsible for joint loading during gait? |
| title_full | Are changes in radiological leg alignment and femoral parameters after total hip replacement responsible for joint loading during gait? |
| title_fullStr | Are changes in radiological leg alignment and femoral parameters after total hip replacement responsible for joint loading during gait? |
| title_full_unstemmed | Are changes in radiological leg alignment and femoral parameters after total hip replacement responsible for joint loading during gait? |
| title_short | Are changes in radiological leg alignment and femoral parameters after total hip replacement responsible for joint loading during gait? |
| title_sort | are changes in radiological leg alignment and femoral parameters after total hip replacement responsible for joint loading during gait |
| topic | Total hip replacement Leg alignment Unilateral hip osteoarthritis Gait analysis Joint loading |
| url | http://link.springer.com/article/10.1186/s12891-019-2832-5 |
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