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Contralateral hip and knee gait biomechanics are unchanged by total hip replacement for unilateral hip osteoarthritis.
MedLine Citation:
PMID:  21903396     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Both the hip and knee contralateral to a total hip replacement (THR) have an increased risk of osteoarthritis (OA) progression, and ultimate joint replacement. It is also known that abnormal gait contributes to OA progression. For these reasons, we conducted a longitudinal analysis of contralateral hip and knee gait during the first year after unilateral THR to determine whether abnormal contralateral gait biomechanics emerge after THR. We analyzed the sagittal plane dynamic range of motion and 3D peak external moments from the asymptomatic hip and knee contralateral to a THR in a group of 26 subjects, evaluated preoperatively, and 3, 12, 24, and 52 weeks after THR, and a group of control subjects. We used t-tests and repeated measures ANOVA to test the hypotheses that contralateral hip and knee gait parameters are normal preoperatively, but change after THR. Preoperatively, the contralateral hip abduction moment and the contralateral knee adduction, flexion, and external rotation moments were significantly higher than normal in the THR group (p≤0.048). Apart from the peak hip extension moment, which decreased three weeks after surgery but returned to its preoperative value thereafter, there were no longitudinal changes during the study period (p≥0.141). Preoperative gait abnormalities persisted postoperatively. Notably, the contralateral knee adduction moment was 32% higher than normal in the THR group. These results indicate a biomechanical basis for the increased contralateral OA risk after unilateral THR, and suggest that some patients may benefit from strategies to reduce loading on the contralateral limb.
Authors:
Kharma C Foucher; Markus A Wimmer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-6
Journal Detail:
Title:  Gait & posture     Volume:  -     ISSN:  1879-2219     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9416830     Medline TA:  Gait Posture     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier B.V. All rights reserved.
Affiliation:
Department of Orthopedic Surgery, Rush University Medical Center, USA.
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