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Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_1 | Pages 34 - 34
1 Feb 2021
Boekesteijn R Smolders J Busch V Smulders K Geurts A
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Introduction

Wearable sensors are promising tools for fast clinical gait evaluations in individuals with osteoarthritis (OA) of the knee and hip. However, gait assessments with wearable sensor are often limited to relatively simple straight-ahead walking paradigms. Parameters reflecting more complex and relevant aspects of gait, including dual-tasking, turning, and compensatory upper body motion are often overlooked in literature. The aim of this study was to investigate turning, dual-task performance, and upper body motion in individuals with knee or hip OA in addition to spatiotemporal gait parameters, taking shared covariance between gait parameters into account.

Methods

Gait was compared between individuals with unilateral knee (n=25) or hip (n=26) OA scheduled for joint replacement, and healthy controls (n=27). For 2 minutes, subjects walked back-and-forth a 6 meter trajectory making 180 degree turns, with and without a secondary cognitive task. Gait parameters were collected using four inertial measurement units on feet, waist, and trunk. To test if turning, dual-tasking, and upper body motion had added value above common spatiotemporal parameters, a factor analysis was conducted. Standardized mean differences were computed for the comparison between knee or hip OA and healthy controls. One gait parameter was selected per gait domain based on factor loading and effect size for the comparison between OA groups and healthy controls.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_4 | Pages 26 - 26
1 Apr 2019
Smulders K Bongers J Nijhof M
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Aim

The aim of this study is to evaluate if obesity negatively affects: (1) complication rate, (2) reoperation and revision rate and (3) functional outcome (based on patient reported outcome measures, PROMs) in revision total hip arthroplasty (rTHA). To our knowledge this is the only recent study to prospectively review these three aspects in what might be considered challenging rTHA.

Methods

444 rTHAs (cup, stem, both, n= 265, 57, 122 respectively), performed in a specialized high-volume orthopaedic center from 2013 to 2015, were prospectively followed. Complications and Oxford Hip Score (OHS) were evaluated at 4 months, 1 year and 2 years. Thirtyfour patients had a BMI >35 kg/m2 (obese), of which thirteen patients with a BMI >40 kg/m2 (morbidly obese).


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_5 | Pages 88 - 88
1 Apr 2019
Smulders K Rensch PV Wymenga A Heesterbeek P Groen B
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Background

The cruciate ligaments are important structures for biomechanical stability of the knee. For total knee arthroplasty (TKA), understanding of the exact function of the (PCL) and anterior (ACL) cruciate ligament during walking is important in the light of recent designs of bicruciate TKAs. However, studies evaluating in vivo function of the PCL during daily activities such as walking are scarce. We aimed to assess the role of the PCL during gait by measuring kinematics and kinetics of individuals with PCL deficiency and compare them with individuals with ACL deficiency and healthy young adults.

Methods

Individuals with unilateral PCL deficiency (PCLD; n=9), unilateral ACL deficiency (n=10) and healthy young adults performed (n=10) 10 walk trials (5 for each leg) in which they walked over a force platform. Motion analysis (Vicon Motion Capture System) was used to calculate joint angles and internal moments around the knee, hip and ankle in the sagittal plane. Joint angles and moments of the injured knee (in PCLD and ACLD) or left knee (in HYA) were compared between groups at weight acceptance, mid-stance and push-off phases (see Fig. 1). Clinical assessment included passive knee laxity (Kneelax) for anterior (in 20–30° knee flexion) and posterior tibia translation (in 70–90° knee flexion) and Lysholm questionnaires.