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General Orthopaedics

BIOMECHANICAL ASSESSMENT OF PATIENTS TREATED BY DIRECT ANTERIOR APPROACH HIP ARTHROPLASTY

The International Society for Technology in Arthroplasty (ISTA), 27th Annual Congress. PART 2.



Abstract

BACKGROUND

Hip arthroplasty is an ultimate treatment for individuals with severe hip osteoarthritis. There are several available approaches when performing this type of surgery, however there is a growing interest in using the least invasive procedures. These less invasive procedures aid in healthy bone preservation which may be particularly important for younger populations undergoing hip arthoplasy (Rajakulendran & Field, 2012). Accurate and reliable measurement techniques are needed to better study and monitor the outcome of different implantation techniques during the postop recovery.

OBJECTIVES

To develop a better understanding of spatiotemporal aspects of gait pre- and post- hip arthroplasty through the anterior approach.

METHODS

Six subjects treated with an anterior approach hip-arthroplasty were instructed to walk over a 30 foot walkway while wearing a lumbar gait sensor that is equipped with an accelerometer and gyroscope used to track changes in body position and hip angles. Subjects were tested before surgery, 3 and 6 weeks post-surgery, and 3 and 6 months post-surgery. The subjects were compared to healthy, age-matched controls.

RESULTS

The use of this device enabled the measurement of consistent gait temporal characteristics throughout the different time points. It was found that spatiotemporal parameters improved as time progressed post-surgery. Furthermore, it is noted that the most substantial improvements were observed after the six week mark with a possible plateauing observed after the three month mark. The following figures illustrate the changes over time experienced by a subject. Their data is also compared to that of a healthy control. Figure 1 summarizes the 6-month follow up results of a female subject with anterior approach THA.

CONCLUSIONS

The greatest improvements in performance were observed as early as 6 weeks post-surgery in some of the subjects. The data also suggests that improvements may plateau after 3 months post-surgery. These biomechanical findings may help with post-surgical physical activity and therapeutic recommendations as well as providing clinicians with a better prognosis time frame for the anterior approach hip arthroplasty.


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