TY - JOUR
T1 - Lower functioning patients demonstrate atypical hip joint loading before and following total hip arthroplasty for osteoarthritis
AU - Bahl, Jasvir S.
AU - Arnold, John B.
AU - Taylor, Mark
AU - Solomon, Lucian B.
AU - Thewlis, Dominic
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Previous studies have established that up to 1 year post total hip arthroplasty (THA), patients do not recover normal function and the magnitude of hip joint loading remains reduced compared to healthy individuals. However, the temporal nature of the loading profile has not been considered to identify individuals who are at a greater risk of poor functional outcomes following THA. This study aimed to determine changes to the profile and magnitude of the resultant hip joint reaction force before and up to 6 months post-primary THA, and factors associated with atypical loading profiles. Hip joint loading was computed using a personalized lower-limb musculoskeletal model in 43 participants awaiting primary THA for osteoarthritis (mean age: SD = 65, 14 years; body mass index: SD = 30, 5 kg/m2) before and up to 6 months after THA. Atypical, single-peak loading profiles were observed for 11 patients before surgery, where four showed a single peak at 6 months. Patients displaying a single-peak profile walked slower (mean difference: −0.4 m/s) compared to individuals displaying double-peak profile (P = <.001) and had significantly reduced sagittal plane hip range of motion during gait (mean difference −9.6°, P = <.001). Self-reported pain, function, and stiffness did not differentiate between patients with a single or double-peak loading profile. Individuals with a single-peak force profile did not meet the minimal clinically important hip range of motion during gait and would be classified as low-functioning THA patients. Clinical Relevance: The temporal nature of the force profile may help to identify individuals who are at the greatest risk of poor functional outcomes after THA.
AB - Previous studies have established that up to 1 year post total hip arthroplasty (THA), patients do not recover normal function and the magnitude of hip joint loading remains reduced compared to healthy individuals. However, the temporal nature of the loading profile has not been considered to identify individuals who are at a greater risk of poor functional outcomes following THA. This study aimed to determine changes to the profile and magnitude of the resultant hip joint reaction force before and up to 6 months post-primary THA, and factors associated with atypical loading profiles. Hip joint loading was computed using a personalized lower-limb musculoskeletal model in 43 participants awaiting primary THA for osteoarthritis (mean age: SD = 65, 14 years; body mass index: SD = 30, 5 kg/m2) before and up to 6 months after THA. Atypical, single-peak loading profiles were observed for 11 patients before surgery, where four showed a single peak at 6 months. Patients displaying a single-peak profile walked slower (mean difference: −0.4 m/s) compared to individuals displaying double-peak profile (P = <.001) and had significantly reduced sagittal plane hip range of motion during gait (mean difference −9.6°, P = <.001). Self-reported pain, function, and stiffness did not differentiate between patients with a single or double-peak loading profile. Individuals with a single-peak force profile did not meet the minimal clinically important hip range of motion during gait and would be classified as low-functioning THA patients. Clinical Relevance: The temporal nature of the force profile may help to identify individuals who are at the greatest risk of poor functional outcomes after THA.
KW - function
KW - hip reaction force
KW - musculoskeletal modeling
KW - OpenSim
KW - osteoarthritis
KW - total hip arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=85085544283&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1120560
UR - http://purl.org/au-research/grants/NHMRC/1126229
U2 - 10.1002/jor.24716
DO - 10.1002/jor.24716
M3 - Article
C2 - 32401407
AN - SCOPUS:85085544283
VL - 38
SP - 1550
EP - 1558
JO - Journal of Orthopaedic Research
JF - Journal of Orthopaedic Research
SN - 0736-0266
IS - 7
ER -