Dynamic Acetabular Cup Orientation during Gait: A Study of Fast- and Slow-Walking Total Hip Replacement Patients
The dynamic orientation of total hip replacement acetabular cups during walking may vary substantially from their assumed position at surgical implantation and may vary between individuals. The scale of this effect is of interest for both pre-clinical device testing and for pre-operative surgical pl...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Bioengineering |
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| Online Access: | https://www.mdpi.com/2306-5354/11/2/151 |
| _version_ | 1797298932126056448 |
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| author | Ksenija Vasiljeva David Lunn Graham Chapman Anthony Redmond Lin Wang Jonathan Thompson Sophie Williams Ruth Wilcox Alison Jones |
| author_facet | Ksenija Vasiljeva David Lunn Graham Chapman Anthony Redmond Lin Wang Jonathan Thompson Sophie Williams Ruth Wilcox Alison Jones |
| author_sort | Ksenija Vasiljeva |
| collection | DOAJ |
| description | The dynamic orientation of total hip replacement acetabular cups during walking may vary substantially from their assumed position at surgical implantation and may vary between individuals. The scale of this effect is of interest for both pre-clinical device testing and for pre-operative surgical planning. This work aimed to evaluate (1) patient variation in dynamic cup orientation; (2) whether walking speed was a candidate proxy measure for the dynamic cup orientation; and (3) the relationships between dynamic cup orientation angles and planar pelvic angles. Pelvic movement data for patients with fast (20 patients) and slow (19 patients) self-selected walking speeds were used to calculate acetabular cup inclination and version angles through gait. For aim 1, the range and extremes of acetabular cup orientation angles were analysed for all patients. A large patient-to-patient variation was found in the ranges of both inclination angle (1° to 11°) and version angle (4° to 18°). The version angle was typically retroverted in comparison to the implantation position (greatest deviation 27°). This orientation is substantially different to the static, 0° version, simplifying assumptions in pre-clinical ‘edge loading’ testing. For aim 2, the cup orientation angles were compared between the fast- and slow-walking groups using statistical parametric mapping. The only significant differences observed were for cup version angle, during ~12% of the gait cycle before toe-off (<i>p</i> < 0.05). Therefore, self-selected walking speed, in isolation, is not a sufficient proxy measure for dynamic acetabular orientation. For aim 3, correlations were recorded between the acetabular cup orientation angles and the planar pelvic angles. The cup inclination angle during gait was strongly correlated (Spearman’s coefficient −1) with pelvic obliquity alone, indicating that simple planar assessment could be used to anticipate inclination angle range. The cup version angle was correlated with both pelvic rotation and tilt (Spearman’s coefficient 0.8–1), indicating that cup version cannot be predicted directly from any single pelvic movement. This complexity, along with the interaction between inclination angle and range of version angle, supports the use of computational tools to aid clinical understanding. |
| first_indexed | 2024-03-07T22:42:12Z |
| format | Article |
| id | doaj.art-fb56e6304f4242d7a5e60bed2ec6e8c4 |
| institution | Directory Open Access Journal |
| issn | 2306-5354 |
| language | English |
| last_indexed | 2024-03-07T22:42:12Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Bioengineering |
| spelling | doaj.art-fb56e6304f4242d7a5e60bed2ec6e8c42024-02-23T15:07:57ZengMDPI AGBioengineering2306-53542024-02-0111215110.3390/bioengineering11020151Dynamic Acetabular Cup Orientation during Gait: A Study of Fast- and Slow-Walking Total Hip Replacement PatientsKsenija Vasiljeva0David Lunn1Graham Chapman2Anthony Redmond3Lin Wang4Jonathan Thompson5Sophie Williams6Ruth Wilcox7Alison Jones8Leeds Institute of Medical and Biological Engineering, University of Leeds, Leeds LS2 9JT, UKLeeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS2 9JT, UKLeeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS2 9JT, UKLeeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS2 9JT, UKLeeds Institute of Medical and Biological Engineering, University of Leeds, Leeds LS2 9JT, UKLeeds Institute of Medical and Biological Engineering, University of Leeds, Leeds LS2 9JT, UKLeeds Institute of Medical and Biological Engineering, University of Leeds, Leeds LS2 9JT, UKLeeds Institute of Medical and Biological Engineering, University of Leeds, Leeds LS2 9JT, UKLeeds Institute of Medical and Biological Engineering, University of Leeds, Leeds LS2 9JT, UKThe dynamic orientation of total hip replacement acetabular cups during walking may vary substantially from their assumed position at surgical implantation and may vary between individuals. The scale of this effect is of interest for both pre-clinical device testing and for pre-operative surgical planning. This work aimed to evaluate (1) patient variation in dynamic cup orientation; (2) whether walking speed was a candidate proxy measure for the dynamic cup orientation; and (3) the relationships between dynamic cup orientation angles and planar pelvic angles. Pelvic movement data for patients with fast (20 patients) and slow (19 patients) self-selected walking speeds were used to calculate acetabular cup inclination and version angles through gait. For aim 1, the range and extremes of acetabular cup orientation angles were analysed for all patients. A large patient-to-patient variation was found in the ranges of both inclination angle (1° to 11°) and version angle (4° to 18°). The version angle was typically retroverted in comparison to the implantation position (greatest deviation 27°). This orientation is substantially different to the static, 0° version, simplifying assumptions in pre-clinical ‘edge loading’ testing. For aim 2, the cup orientation angles were compared between the fast- and slow-walking groups using statistical parametric mapping. The only significant differences observed were for cup version angle, during ~12% of the gait cycle before toe-off (<i>p</i> < 0.05). Therefore, self-selected walking speed, in isolation, is not a sufficient proxy measure for dynamic acetabular orientation. For aim 3, correlations were recorded between the acetabular cup orientation angles and the planar pelvic angles. The cup inclination angle during gait was strongly correlated (Spearman’s coefficient −1) with pelvic obliquity alone, indicating that simple planar assessment could be used to anticipate inclination angle range. The cup version angle was correlated with both pelvic rotation and tilt (Spearman’s coefficient 0.8–1), indicating that cup version cannot be predicted directly from any single pelvic movement. This complexity, along with the interaction between inclination angle and range of version angle, supports the use of computational tools to aid clinical understanding.https://www.mdpi.com/2306-5354/11/2/151total hip replacementacetabular cuppelvic movementwalking speed |
| spellingShingle | Ksenija Vasiljeva David Lunn Graham Chapman Anthony Redmond Lin Wang Jonathan Thompson Sophie Williams Ruth Wilcox Alison Jones Dynamic Acetabular Cup Orientation during Gait: A Study of Fast- and Slow-Walking Total Hip Replacement Patients Bioengineering total hip replacement acetabular cup pelvic movement walking speed |
| title | Dynamic Acetabular Cup Orientation during Gait: A Study of Fast- and Slow-Walking Total Hip Replacement Patients |
| title_full | Dynamic Acetabular Cup Orientation during Gait: A Study of Fast- and Slow-Walking Total Hip Replacement Patients |
| title_fullStr | Dynamic Acetabular Cup Orientation during Gait: A Study of Fast- and Slow-Walking Total Hip Replacement Patients |
| title_full_unstemmed | Dynamic Acetabular Cup Orientation during Gait: A Study of Fast- and Slow-Walking Total Hip Replacement Patients |
| title_short | Dynamic Acetabular Cup Orientation during Gait: A Study of Fast- and Slow-Walking Total Hip Replacement Patients |
| title_sort | dynamic acetabular cup orientation during gait a study of fast and slow walking total hip replacement patients |
| topic | total hip replacement acetabular cup pelvic movement walking speed |
| url | https://www.mdpi.com/2306-5354/11/2/151 |
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