Abstract
Background
Long-term favorable clinical outcomes of anatomical or high hip center techniques
in total hip arthroplasty (THA) are reported in patients with developmental dysplasia
of the hip (DDH). However, there is little information about the effect of the hip
center location on gait characteristics. The purpose of this study was to compare
these surgical techniques with gait analysis, analyze the effect of the hip rotation
center location on gait parameters, and discuss the possible problems that may arise.
Methods
A total of 40 patients who underwent THA due to unilateral coxarthrosis secondary
to Crowe type III-IV DDH and completed 5 years of follow-up were included in the study.
Group 1 included 20 patients who underwent anatomical hip center reconstruction, while
group 2 included 20 patients who underwent high hip center reconstruction. Gait analysis
was performed, and the groups were compared according to the gait characteristics.
Results
The mean temporospatial values were similar between the groups. The extension of the
operated side was significantly lower in group 2 (−9.11 ± 8.92) than in group 1 (−1.87
± 11.51) (P = .04). The mean longitudinal hip joint force was found to be significantly higher
in group 2 (8.92 N/kg ± 0.54) than in group 1 (8.16 N/kg ± 0.66) (P = .04). The high hip center technique has been shown to increase the load on the
hip and restrict the dynamic range of motion.
Conclusion
The high hip center technique can decrease the survival of the implant and increase
the fall risk as it increases the load on the hip and reduces the dynamic range of
motion. The hip center should be reconstructed anatomically when possible in DDH patients
who undergo unilateral THA.
Keywords
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Article Info
Publication History
Published online: February 18, 2019
Accepted:
February 12,
2019
Received in revised form:
February 4,
2019
Received:
January 2,
2019
Footnotes
No author associated with this paper has disclosed any potential or pertinent conflicts which may be perceived to have impending conflict with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2019.02.017.
Funding: This work was supported by the Scientific Research Project Coordination Unit of Istanbul University, Turkey (grant number 20876 ).
Compliance with Ethical Standards: All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Written and signed informed consent was obtained from all patients.
Identification
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