Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis

Despite good clinical functional outcome, deficits in gait biomechanics exist 2 years after total hip replacement surgery. The aims of this research were (1) to group patients showing similar gait adaptations to hip osteoarthritis and (2) to investigate the effect of the surgical treatment on gait k...

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Main Authors: Stefan van Drongelen, Bernd J. Stetter, Harald Böhm, Felix Stief, Thorsten Stein, Andrea Meurer
Format: Article
Language:English
Published: MDPI AG 2021-05-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/10/10/2167
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spelling doaj-23384b1132434399b874911cd33783302021-06-01T00:17:34ZengMDPI AGJournal of Clinical Medicine2077-03832021-05-01102167216710.3390/jcm10102167Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary AnalysisStefan van Drongelen0Bernd J. Stetter1Harald Böhm2Felix Stief3Thorsten Stein4Andrea Meurer5Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60528 Frankfurt/Main, GermanyInstitute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, GermanyOrthopedic Hospital for Children, Behandlungszentrum Aschau gGmbH, 83229 Aschaui im Chiemgau, GermanyDepartment of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60528 Frankfurt/Main, GermanyInstitute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, GermanyDepartment of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60528 Frankfurt/Main, GermanyDespite good clinical functional outcome, deficits in gait biomechanics exist 2 years after total hip replacement surgery. The aims of this research were (1) to group patients showing similar gait adaptations to hip osteoarthritis and (2) to investigate the effect of the surgical treatment on gait kinematics and external joint moments. In a secondary analysis, gait data of 51 patients with unilateral hip osteoarthritis were analyzed. A k-means cluster analysis was performed on scores derived via a principal component analysis of the gait kinematics. Preoperative and postoperative datasets were statistically tested between clusters and 46 healthy controls. The first three principal components incorporated hip flexion/extension, pelvic tilt, foot progression angle and thorax tilt. Two clusters were discriminated best by the peak hip extension during terminal stance. Both clusters deviated from healthy controls in spatio-temporal, kinematic and kinetic parameters. The cluster with less hip extension deviated significantly more. The clusters improved postoperatively but differences to healthy controls were still present one year after surgery. A poor preoperative gait pattern in patients with unilateral hip osteoarthritis is associated with worse gait kinematics after total hip replacement. Further research should focus on the identification of patients who can benefit from an adapted or individualized rehabilitation program.https://www.mdpi.com/2077-0383/10/10/2167unilateral hip osteoarthritisclassification3D gait analysistotal hip replacementcluster analysis
collection DOAJ
language English
format Article
sources DOAJ
author Stefan van Drongelen
Bernd J. Stetter
Harald Böhm
Felix Stief
Thorsten Stein
Andrea Meurer
spellingShingle Stefan van Drongelen
Bernd J. Stetter
Harald Böhm
Felix Stief
Thorsten Stein
Andrea Meurer
Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis
Journal of Clinical Medicine
unilateral hip osteoarthritis
classification
3D gait analysis
total hip replacement
cluster analysis
author_facet Stefan van Drongelen
Bernd J. Stetter
Harald Böhm
Felix Stief
Thorsten Stein
Andrea Meurer
author_sort Stefan van Drongelen
title Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis
title_short Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis
title_full Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis
title_fullStr Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis
title_full_unstemmed Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis
title_sort identification of patients with similar gait compensating strategies due to unilateral hip osteoarthritis and the effect of total hip replacement: a secondary analysis
publisher MDPI AG
series Journal of Clinical Medicine
issn 2077-0383
publishDate 2021-05-01
description Despite good clinical functional outcome, deficits in gait biomechanics exist 2 years after total hip replacement surgery. The aims of this research were (1) to group patients showing similar gait adaptations to hip osteoarthritis and (2) to investigate the effect of the surgical treatment on gait kinematics and external joint moments. In a secondary analysis, gait data of 51 patients with unilateral hip osteoarthritis were analyzed. A k-means cluster analysis was performed on scores derived via a principal component analysis of the gait kinematics. Preoperative and postoperative datasets were statistically tested between clusters and 46 healthy controls. The first three principal components incorporated hip flexion/extension, pelvic tilt, foot progression angle and thorax tilt. Two clusters were discriminated best by the peak hip extension during terminal stance. Both clusters deviated from healthy controls in spatio-temporal, kinematic and kinetic parameters. The cluster with less hip extension deviated significantly more. The clusters improved postoperatively but differences to healthy controls were still present one year after surgery. A poor preoperative gait pattern in patients with unilateral hip osteoarthritis is associated with worse gait kinematics after total hip replacement. Further research should focus on the identification of patients who can benefit from an adapted or individualized rehabilitation program.
topic unilateral hip osteoarthritis
classification
3D gait analysis
total hip replacement
cluster analysis
url https://www.mdpi.com/2077-0383/10/10/2167
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