Biomechanical gait features associated with hip osteoarthritis: Towards a better definition of clinical hallmarks

Critical appraisal of the literature highlights that the discriminative power of gait‐related features in patients with hip osteoarthritis (OA) has not been fully explored. We aimed to reduce the number of gait‐related features and define the most discriminative ones comparing the three‐dimensional gait analysis of 20 patients with hip osteoarthritis (OA) with those of 17 healthy peers. First, principal component analysis was used to reduce the high‐dimensional gait data into a reduced set of interpretable variables for further analysis, including tests for group differences. These differences were indicative for the selection of the top 10 variables to be included into linear discriminant analysis models (LDA). Our findings demonstrated the successful data reduction of hip osteoarthritic‐related gait features with a high discriminatory power. The combination of the top variables into LDA models clearly separated groups, with a maximum misclassification error rate of 19%, estimated by cross‐validation. Decreased hip/knee extension, hip flexion and internal rotation moment were gait features with the highest discriminatory power. This study listed the most clinically relevant gait features characteristics of hip OA. Moreover, it will help clinicians and physiotherapists understand the movement pathomechanics related to hip OA useful in the management and design of rehabilitation intervention. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1498–1507, 2015.     

Temporal-spatial gait adaptations during stair ascent and descent in patients with knee osteoarthritis

Knee osteoarthritis (OA) accounts for more functional disability of the lower extremity than any other disease. We recruited 18 patients with knee OA and 18 healthy age-, height-, mass-, and gender-matched control subjects to investigate the effects knee OA has on select spatial and temporal gait variables during a stair climbing task. No group-by-direction interaction was observed; however, significant effects did occur for group and direction. Specifically, patients with knee OA demonstrated less time in single support, greater time in double support, decreased step length, greater step width, less stride length, decreased total gait velocity, greater total time in support, and less total time in swing, compared with controls. Early-stage knee OA directly influences specific temporal and spatial gait characteristics during stair climbing.     

The Effect of Total Knee Arthroplasty on Knee Joint Kinematics and Kinetics During Gait

This study determined how total knee arthroplasty (TKA) altered knee motion and loading during gait. Three-dimensional kinematic and kinetic gait patterns of 42 patients with severe knee osteoarthritis were collected 1 week prior and 1-year post-TKA. Principal component analysis extracted major patterns of variability in the gait waveforms. Overall and midstance knee adduction moment magnitude decreased. Overall knee flexion angle magnitude increased due to an increase during swing. Increases in the early stance knee flexion moment and late stance knee extension moment were found, indicating improved impact attenuation and function. A decrease in the early stance knee external rotation moment indicated alteration in the typical rotation mechanism. Most changes moved toward an asymptomatic pattern and would be considered improvements in motion, function, and loading.     

Position of the Hip in Yoga

Background

Yoga is growing in popularity as a form of exercise throughout the world. Orthopedic patients participate in yoga, yet little is known about the ranges-of-motion of the hip within various yoga poses. Orthopedic surgeons are unsure about what potential positions their patients are placing their hips during a yoga practice. The aim of this study is to quantify the degree of hip motion with common yoga poses.

Leg length change in total hip arthroplasty with subtrochanteric femoral shortening osteotomy for Crowe type IV developmental hip dysplasia

Primary total hip arthroplasties were performed in 70 hips for the treatment of Crowe type IV developmental dysplasia of the hip. The patients were subdivided into 2 groups with or without iliofemoral osteoarthritis. Leg length change was measured radiographically. Preoperative hip motion was reviewed from medical records and defined as either higher or lower motion groups. The leg length change in patients without iliofemoral osteoarthritis was significantly greater than that in patients with iliofemoral osteoarthritis, and the higher hip motion group had greater leg length change in total hip arthroplasty than the lower motion group. The current study identifies several features that might help predict leg length change during the preoperative planning of total hip arthroplasty for Crowe type IV developmental hip dysplasia.     

Deformity correction with the Taylor spatial frame after growth arrest of the distal radius: A technical note on 2 cases

The anteversion angle (AV-angle) of the femur was measured according to the method of Rippstein in a series of 50 patients with “primary” osteoarthritis of the hip, and in a control group of 30 individuals of the same age without hip disease. The median AV-angle of the hips in osteoarthritic patients was 17.5°, and in the control group 13°. Osteoarthritic patients had a significantly increased AV-angle in relation to the control group (P = 0.0028). The greatest AV-angle in the hips of the control group was 25°. In 18 hips of osteoarthritic patients an AV-angle greater than 25° was found. Osteoarthritis was found in 15 of these hips; there was no osteoarthritis in the remaining 3 hips.

Our results lead to the conclusion that increased femoral anteversion is a predisposing factor for hip osteoarthritis. This implies that derotational osteotomy in children can be a prophylactic procedure.     

Increased Femoral Anteversion and Osteoarthritis of the Hip Joint

The anteversion angle (AV-angle) of the femur was measured according to the method of Rippstein in a series of 50 patients with “primary” osteoarthritis of the hip, and in a control group of 30 individuals of the same age without hip disease. The median AV-angle of the hips in osteoarthritic patients was 17.5°, and in the control group 13°. Osteoarthritic patients had a significantly increased AV-angle in relation to the control group (P = 0.0028). The greatest AV-angle in the hips of the control group was 25°. In 18 hips of osteoarthritic patients an AV-angle greater than 25° was found. Osteoarthritis was found in 15 of these hips; there was no osteoarthritis in the remaining 3 hips.

Our results lead to the conclusion that increased femoral anteversion is a predisposing factor for hip osteoarthritis. This implies that derotational osteotomy in children can be a prophylactic procedure.     

Dynamic measurements of hip movement in deep bending activities after total hip arthroplasty using a 4-dimensional motion analysis system

Although deep hip bending activities are often required in Asian populations because of traditional lifestyles and religious practices, few have examined the required hip range of motion (ROM) in these activities after total hip arthroplasty (THA). We performed postoperative motion analysis to evaluate the differences in required ROMs between Japanese-style and Western-style deep hip bending activities, to investigate whether prosthetic impingement would occur during these activities and to clarify the necessity for precautions in these activities after THA. Japanese-style activities did not require larger hip ROMs than Western-style ones, and all required hip flexion angles were less than 120°. Prosthetic impingement was not observed, with a safety margin 10° or higher until impingement in any directions of flexion, adduction, or internal rotation for any activities. Thus, particular postoperative precautions for Japanese-style activities are not required.     

全髋置换术治疗晚期髋关节骨关节炎

目的 探讨全髋置换术(THA)治疗晚期髋关节骨关节炎的疗效.方法 对46例(65髋) 晚期髋关节骨关节炎患者行全髋置换术.采用Harris髋评分系统评估临床疗效, X线观察评估股骨侧假体的移位与稳定性.结果 46例均获得随访, 时间1年2个月～5年.术后Harris评分平均为(88±4.0)分,优46髋,良8髋,一般9髋,差2髋,优良率为85%.1例发生移位,经药物治疗后好转.结论 全髋置换术是治疗晚期髋关节骨关节炎的有效方法.