Direct anterior approach for total hip arthroplasty: Hip biomechanics and muscle activation during three walking tasks |
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| Affiliation: | 1. Istituto Chirurgico Ortopedico Traumatologico, Via Franco Faggiana, 1668 Latina, Italy;2. Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, Latina, Italy;3. Movement Analysis LAB, Policlinico Italia, Piazza del Campidano 6, Rome, Italy;4. IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy;5. Department of Neuroscience, Mental Health, and Sense Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, via di Grottarossa 1035-1039, Rome, Italy;6. IRCCS Neuromed, Via Atinense 18, Pozzili, Isernia, Italy;7. Department of Mechanical and Aerospace Engineering, Mechanical & Thermal Measurement Lab, Sapienza University of Rome, Via Eudossiana 18, Rome, Italy;1. CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France;2. CIAMS laboratory, Université d''Orléans, 45067 Orléans, France;1. Department of Orthopaedics, Midlands Regional Hospital Tullamore, Ireland;2. School of Medicine, University College Dublin, Ireland;3. Department of Orthopaedics, National Orthopaedic Hospital Cappagh, Ireland;1. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands;2. Amsterdam UMC, University of Amsterdam, Medical Imaging Quantification Center (MIQC), Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands;3. Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia;4. Delft University of Technology, Department of Biomechanical Engineering, Delft, the Netherlands;5. Erasmus Medical Center, Department of Orthopedics, Rotterdam, the Netherlands;6. Amsterdam Rehabilitation Research Center, Reade, Amsterdam, the Netherlands;7. Centre of Expertise Urban vitality, Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands;1. Department of Orthopaedics, Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, PR China;2. Orthopaedic Biomechanics Laboratory, Fujian Medical University, Quanzhou, Fujian, PR China;3. Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands;4. Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands;5. Research and Development, Military Rehabilitation Center ‘Aardenburg’, Doorn, the Netherlands |
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| Abstract: | BackgroundTotal hip replacement with minimally invasive direct anterior approach using the “Smith Petersen” interval is an alternative technique to conventional surgery aimed at preserving the integrity of the muscles around the hip joint. This study aimed to observe hip biomechanics, gait variables, hip muscle activation and locomotor performance during three locomotor tasks (forward, lateral, and backward walking), in subjects who undergo total hip arthroplasty with direct anterior approach.MethodsFourteen patients with primary osteoarthritis who underwent direct anterior approach were included in the study. The optoelectronic 3-D motion analysis system integrated with an electromyography surface device was used to acquire the biomechanics of patients before surgery and at 3 and 6 months post-surgery. Spatio-temporal, dynamic, and hip muscle electromyographic parameters were analyzed and compared whit those of healthy controls.FindingsAlmost all gait parameters improved after surgery. The majority of gait variables neared to the control group at 6 months, while the hip joint range of motion did not. The abnormally increased activation of the muscles around the hip joint was reduced at 6 months post-surgery during all three locomotor tasks. Conversely, the altered gait phase-related electromyographic pattern did not change after the surgery.InterpretationOur results indicate that hip and gait function during several locomotor tasks improved after surgery, while simultaneously either preserve or restore the muscle activation around the hip joint. A full biomechanical evaluation of the hip function during locomotion may aid physicians and surgeons in optimizing the management of patients before and after hip replacement surgery. |
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