Article

Musculoskeletal loading is an important factor affecting the development of
osteoarthritis, bone remodelling and primary fixation of total hip replacement
(THR). In this study, we analyzed the relation between muscular force, gait
kinematics and kinetics and hip loading in 20 patients before and six weeks after
THR. Hip contact forces were calculated from gait analysis data using musculoskeletal modelling, inverse dynamics and static optimization. We found
aberrant pelvis and hip kinematics and kinetics before and six weeks after
surgery, confirming previous findings in literature. Furthermore, we found a
decrease in the total contact force and its vertical component. These changes
result in a decrease of the associated inclination angles of the total hip
contact force in the sagittal and transverse planes, changing the orientation
towards more vertical implant loading after THR. These changes in hip loading
were related to observed gait kinematics and kinetics. Most importantly,
excessive pelvic obliquity and associated hip adduction related to impaired
implant loading. We concluded, therefore, that physical therapy in the early
post-operative phase should primarily focus on stretching of anterior and medial
structures and strengthening of hip flexors and abductors to achieve normalization of the hip and pelvis kinematics and consequently normalize hip
loading.

Langue : ANGLAIS