Bilateral symmetry in lower extremity mechanics during stair ascent and descent following a total hip arthroplasty: A one-year longitudinal study. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Queen, Robin M.; Attarian, David E.; Bolognesi, Michael P.; Butler, Robert J.
• Is Part Of: Clinical biomechanics. Volume 30:Issue 1(2015)
• Page Start: 53
• Page End: 58
• Publication Date: 2015-01
• Subjects: Biomechanics -- Periodicals; Osteopathic medicine -- Periodicals; Biomechanics -- Periodicals; Osteopathic Medicine -- Periodicals; 612.76
• DOI: 10.1016/j.clinbiomech.2014.11.004
• Languages: English
• ISSNs: 0268-0033

Abstract

<abstract abstract-type="author" id="ab0005"> <title id="st0005">Abstract</title> <sec> <title id="st0085">Background</title> <p id="sp0005">Total hip arthroplasty is the standard treatment to reduce pain and improve function in people with advanced hip osteoarthritis; however, persisting asymmetrical gait patterns have been identified in level walking. Therefore, this study evaluated limb asymmetries during stair ascent and descent in patients pre-operatively through 1 year after a hip replacement. It was hypothesized that lower extremity mechanics would improve on the surgical side, but asymmetries would persist through one year.</p> </sec> <sec> <title id="st0090">Methods</title> <p id="sp0010">Kinematics and kinetics were collected during seven ascending and descending trials pre-operatively, 6 weeks, and 1 year post-operatively for 42 hip replacement patients. Data were analyzed using 2 ∗ 3 (Limb ∗ Time) within-subject repeated measures analyses of variance (ANOVAs) to determine significant differences between limbs across time (<italic>P</italic> < .05).</p> </sec> <sec> <title id="st0095">Findings</title> <p id="sp0015">Significant changes across time, independent of limb included: peak hip flexion, extension, and adduction during ascent. Peak hip flexion and extension, hip flexion moment, adduction and abduction moments, and propulsive vertical ground reaction force were different during descent (<italic>P</italic> < .05). Independent of time, significant asymmetries between limbs were observed in peak hip flexion, hip abduction, and hip extension moments during ascent, and in peak hip abduction moment during descent (<italic>P</italic> < .05).</p> </sec> <sec> <title id="st0100">Interpretation</title> <p id="sp0020">Abnormal movement patterns on the surgical side increase demands on other joints and could lead to permanent joint damage. These side-to-side differences in joint mechanics should be addressed during the early post-operative period through additional interventions in an attempt to normalize the differences and potentially improve long-term joint health throughout the lower extremity.</p> </sec> </abstract>