Research Article| Volume 27, ISSUE 8, P1562-1568, September 2012

Dynamic Measurements of Hip Movement in Deep Bending Activities After Total Hip Arthroplasty Using a 4-Dimensional Motion Analysis System

Published:March 29, 2012DOI:


      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.


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        • Sugano N.
        • Nishii T.
        • Miki H.
        • et al.
        Mid-term results of cementless total hip replacement using a ceramic-on-ceramic bearing with and without computer navigation.
        J Bone Joint Surg Br. 2007; 89: 455
        • Wroblewski B.M.
        • Siney P.D.
        • Fleming P.A.
        Effect of reduced diameter neck stem on incidence of radiographic cup loosening and revisions in Charnley low-frictional torque arthroplasty.
        J Arthroplasty. 2009; 24: 10
        • Amstutz H.C.
        • Lodwig R.M.
        • Schurman D.J.
        • et al.
        Range of motion studies for total hip replacements. A comparative study with a new experimental apparatus.
        Clin Orthop Relat Res. 1975; 111: 124
        • Chandler D.R.
        • Glousman R.
        • Hull D.
        • et al.
        Prosthetic hip range of motion and impingement. The effects of head and neck geometry.
        Clin Orthop Relat Res. 1982; 166: 284
        • Herrlin K.
        • Selvik G.
        • Pettersson H.
        • et al.
        Position, orientation and component interaction in dislocation of the total hip prosthesis.
        Acta Radiol. 1988; 29: 441
        • Herrlin K.
        • Selvik G.
        • Pettersson H.
        • et al.
        Range of motion caused by design of the total hip prosthesis.
        Acta Radiol. 1988; 29: 701
        • Nadzadi M.E.
        • Pedersen D.R.
        • Yack H.J.
        • et al.
        Kinematics, kinetics, and finite element analysis of commonplace maneuvers at risk for total hip dislocation.
        J Biomech. 2003; 36: 577
        • Widmer K.H.
        • Zurfluh B.
        Compliant positioning of total hip components for optimal range of motion.
        J Orthop Res. 2004; 22: 815
        • Mulholland S.J.
        • Wyss U.P.
        Activities of daily living in non-Western cultures: range of motion requirements for hip and knee joint implants.
        Int J Rehabil Res. 2001; 24: 191
        • Yamamura M.
        • Miki H.
        • Nakamura N.
        • et al.
        Open-configuration MRI study of femoro-acetabular impingement.
        J Orthop Res. 2007; 25: 1582
        • Hagio K.
        • Sugano N.
        • Nishii T.
        • et al.
        A novel system of four-dimensional motion analysis after total hip arthroplasty.
        J Orthop Res. 2004; 22: 665
        • Otake Y.
        • Suzuki N.
        • Hattori A.
        • et al.
        Four-dimensional model of the lower extremity after total hip arthroplasty.
        J Biomech. 2005; 38: 2397
        • Miki H.
        • Yamanashi W.
        • Nishii T.
        • et al.
        Anatomic hip range of motion after implantation during total hip arthroplasty as measured by a navigation system.
        J Arthroplasty. 2007; 22: 946-952
        • Harris W.H.
        Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation.
        J Bone Joint Surg Am. 1969; 51: 737
        • Paterno S.A.
        • Lachiewicz P.F.
        • Kelley S.S.
        The influence of patient-related factors and the position of the acetabular component on the rate of dislocation after total hip replacement.
        J Bone Joint Surg Am. 1997; 79: 1202
        • Peak E.L.
        • Parvizi J.
        • Ciminiello M.
        • et al.
        The role of patient restrictions in reducing the prevalence of early dislocation following total hip arthroplasty. A randomized, prospective study.
        J Bone Joint Surg Am. 2005; 87: 247
        • Satoh M.
        • Kawaguchi T.
        • Masuhara K.
        Risk factors for revision total hip arthroplasty: emphasis on the characteristics of Japanese lifestyle.
        Arch Orthop Trauma Surg. 2009; 129: 1707
        • Cappozzo A.
        • Catani F.
        • Leardini A.
        • et al.
        Position and orientation in space of bones during movement: experimental artefacts.
        Clin Biomech. 1996; 11: 90
        • Reinschmidt C.
        • van den Bogert A.J.
        • Murphy N.
        • et al.
        Tibiocalcaneal motion during running, measured with external and bone markers.
        Clin Biomech. 1997; 12: 8
        • Reinschmidt C.
        • van den Bogert A.J.
        • Nigg B.M.
        • et al.
        Effect of skin movement on the analysis of skeletal knee joint motion during running.
        J Biomech. 1997; 30: 729
        • Alexander E.J.
        • Andriacchi T.P.
        Correcting for deformation in skin-based marker systems.
        J Biomech. 2001; 34: 355
        • Andriacchi T.P.
        • Alexander E.J.
        • Toney M.K.
        • et al.
        A point cluster method for in vivo motion analysis: applied to a study of knee kinematics.
        J Biomech Eng. 1998; 120: 743
        • Lucchetti L.
        • Cappozzo A.
        • Cappello A.
        • et al.
        Skin movement artefact assessment and compensation in the estimation of knee-joint kinematics.
        J Biomech. 1998; 31: 977
        • Lu T.W.
        • O'Connor J.J.
        Bone position estimation from skin marker co-ordinates using global optimisation with joint constraints.
        J Biomech. 1999; 32: 129
        • Spoor C.W.
        • Veldpaus F.E.
        Rigid body motion calculated from spatial co-ordinates of markers.
        J Biomech. 1980; 13: 391
        • DiGioia A.M.
        • Jaramaz B.
        • Blackwell M.
        • et al.
        The Otto Aufranc Award. Image guided navigation system to measure intraoperatively acetabular implant alignment.
        Clin Orthop Relat Res. 1998; 355: 8
        • Jaramaz B.
        • DiGioia III, A.M.
        • Blackwell M.
        • et al.
        Computer assisted measurement of cup placement in total hip replacement.
        Clin Orthop Relat Res. 1998; 354: 70
        • Hemmerich A.
        • Brown H.
        • Smith S.
        • et al.
        Hip, knee, and ankle kinematics of high range of motion activities of daily living.
        J Orthop Res. 2006; 24: 770