In Vivo analysis of spinopelvic kinematics and peak head‐cup contact in total hip arthroplasty patients with lumbar degenerative disc disease
| Autor: | Young-Min Kwon, David W. Hennessy, Sakkadech Limmahakhun, Paul Arauz, Christian Klemt, Hayden N. Box |
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| Rok vydání: | 2019 |
| Předmět: |
Male
musculoskeletal diseases Pelvic tilt Arthroplasty Replacement Hip Intervertebral Disc Degeneration Kinematics Degenerative disc disease Lumbar medicine Deformity Humans Orthopedics and Sports Medicine Pelvic Bones Gait Aged Lumbar Vertebrae business.industry In vivo analysis Middle Aged medicine.disease Sagittal plane Biomechanical Phenomena medicine.anatomical_structure Case-Control Studies Female Hip Prosthesis medicine.symptom Nuclear medicine business Total hip arthroplasty |
| Zdroj: | Journal of Orthopaedic Research. 37:674-680 |
| ISSN: | 1554-527X 0736-0266 |
| DOI: | 10.1002/jor.24234 |
| Popis: | Anterior instability after total hip arthroplasty (THA) has been described in patients with thoracolumbar kyphotic deformity. Although compensatory posterior pelvic tilt with subsequent increased functional anteversion has been described as the mechanism, there is a paucity of in vivo data. The purpose of our study was to compare pelvic tilt, anteversion, inclination, and position of head-cup contact points in patients with lumbar degenerative disc disease (DDD) and a matched patient cohort without DDD. A total of 50 THA, 18 hips with lumbar DDD and 32 hips without DDD, underwent CT imaging for 3D hip reconstruction. Component orientations and in vivo hip gait kinematics was quantified using a validated dual fluoroscopic imaging system. Hip kinematics and head-cup contact points were compared. Patients with lumbar DDD demonstrated decreased maximum (5.9° ± 4.2° vs. 9.3° ± 5.4°, p = 0.02) and minimum (2.4° ± 4.1° vs. 6.2° ± 5.6°, p = 0.01) anterior pelvic tilt, and increased maximum cup anteversion (29.3° ± 8.7° vs. 25.1° ± 8.1°, p = 0.05). The peak head-cup contact points were shifted closer to the anterior edge of the polyethylene (7.8 ± 1.7 mm vs. 9.6 ± 2.2 mm, p = 0.02). Patients with lumbar degenerative disc disease demonstrated increased posterior pelvic tilt, functional acetabular anteversion, inclination as well as shifting of the peak head-cup contact pattern significantly closer to an anterior edge, suggesting sagittal spinopelvic deformity may predispose to anterior instability in THA patients during upright activities. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. |
| Databáze: | OpenAIRE |
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