Gait pattern in patients treated with a total hip arthroplasty due to an acute displaced cervical neck fracture: a randomised comparison between 29 cases with a cemented femoral stem and 16 cases with an uncemented femoral stem.

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-05-01 Epub Date: 2023-12-12 DOI:10.1177/11207000231208099
Roland Zügner, Roy Tranberg, Bita Sharegi, Johan Kärrholm
{"title":"Gait pattern in patients treated with a total hip arthroplasty due to an acute displaced cervical neck fracture: a randomised comparison between 29 cases with a cemented femoral stem and 16 cases with an uncemented femoral stem.","authors":"Roland Zügner, Roy Tranberg, Bita Sharegi, Johan Kärrholm","doi":"10.1177/11207000231208099","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The choice between cemented or uncemented stem fixation in the treatment of a femoral neck fracture may influence patient rehabilitation and the resulting gait pattern, due to potential differences in implant positioning and fixation. We used gait analysis to study temporal gait parameters, hip kinematics and kinetics in patients who, 2 years previously, had been randomised to treatment with a cemented or uncemented stem and due to an acute femoral neck fracture.</p><p><strong>Methods: </strong>45 Patients implanted with a cemented Lubinus SP II (<i>n</i> = 29) and an uncemented (<i>n</i> = 16) Corail stem were studied. Gait analysis was performed using a 16-camera motion capture system and force plates. 28 subjects served as controls. Temporal gait parameters, hip kinematics and kinetics were analysed. The patients had no or minimum pain (median Harris pain score 44, range 40-44) and the majority had no limp (median Harris limp score 11, range 5-11).</p><p><strong>Results: </strong>Temporospatial gait parameters and abduction-adduction motions and moments did not differ between patients with cemented or uncemented stems (<i>p</i> <i>></i> 0.05). Patients with cemented stems did, however, show more hip flexion and less extension during walking than those with an uncemented stem (<i>p</i> < 0.05). Moreover, the flexion-extension range was less in the cemented group (<i>p</i> < 0.04). Compared with controls, the hip fracture patients walked more slowly, with a shorter stride length and a longer stance phase.</p><p><strong>Conclusions: </strong>Increased hip flexion and reduced extension in patients using the Lubinus SP II cemented stem could be an effect of its anteverted neck, but this question requires further study. Despite acute treatment with THA, hip fracture patients demonstrated a change in gait pattern compared with controls 2 years after the operation. This suggests that these changes are caused by the presence of an implant, or the soft-tissue trauma partly caused by the surgery than by any degenerative disease present in patients undergoing elective surgery.ClinicalTrials.gov Identifier: NCT04791605.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11071595/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"HIP International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/11207000231208099","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/12 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The choice between cemented or uncemented stem fixation in the treatment of a femoral neck fracture may influence patient rehabilitation and the resulting gait pattern, due to potential differences in implant positioning and fixation. We used gait analysis to study temporal gait parameters, hip kinematics and kinetics in patients who, 2 years previously, had been randomised to treatment with a cemented or uncemented stem and due to an acute femoral neck fracture.

Methods: 45 Patients implanted with a cemented Lubinus SP II (n = 29) and an uncemented (n = 16) Corail stem were studied. Gait analysis was performed using a 16-camera motion capture system and force plates. 28 subjects served as controls. Temporal gait parameters, hip kinematics and kinetics were analysed. The patients had no or minimum pain (median Harris pain score 44, range 40-44) and the majority had no limp (median Harris limp score 11, range 5-11).

Results: Temporospatial gait parameters and abduction-adduction motions and moments did not differ between patients with cemented or uncemented stems (p> 0.05). Patients with cemented stems did, however, show more hip flexion and less extension during walking than those with an uncemented stem (p < 0.05). Moreover, the flexion-extension range was less in the cemented group (p < 0.04). Compared with controls, the hip fracture patients walked more slowly, with a shorter stride length and a longer stance phase.

Conclusions: Increased hip flexion and reduced extension in patients using the Lubinus SP II cemented stem could be an effect of its anteverted neck, but this question requires further study. Despite acute treatment with THA, hip fracture patients demonstrated a change in gait pattern compared with controls 2 years after the operation. This suggests that these changes are caused by the presence of an implant, or the soft-tissue trauma partly caused by the surgery than by any degenerative disease present in patients undergoing elective surgery.ClinicalTrials.gov Identifier: NCT04791605.

因急性移位性颈椎骨折而接受全髋关节置换术治疗的患者的步态:对29例使用骨水泥股骨柄和16例使用非骨水泥股骨柄的患者进行随机比较。
背景:在治疗股骨颈骨折时,选择骨水泥或非骨水泥柄固定可能会影响患者的康复和由此产生的步态模式,这是因为植入物的定位和固定可能存在差异。我们使用步态分析法研究了2年前因急性股骨颈骨折而随机接受骨水泥或非骨水泥柄治疗的患者的时间步态参数、髋关节运动学和动力学。使用16摄像头运动捕捉系统和测力板进行步态分析。28 名受试者作为对照组。对时间步态参数、髋关节运动学和动力学进行了分析。患者没有疼痛或疼痛程度较轻(Harris 疼痛评分中位数为 44 分,范围为 40-44 分),大多数患者没有跛行(Harris 跛行评分中位数为 11 分,范围为 5-11 分):结果:使用骨水泥或非骨水泥柄的患者的时空步态参数和外展-内展运动和力矩没有差异(P > 0.05)。然而,与使用非骨水泥柄的患者相比,使用骨水泥柄的患者在行走过程中髋关节屈曲的幅度更大,而伸展的幅度更小(p p 结论:使用骨水泥柄的患者在行走过程中髋关节屈曲的幅度更大,而伸展的幅度更小(p p):使用Lubinus SP II骨水泥柄的患者髋关节屈曲增加,伸展减少,这可能是其前倒颈的影响,但这一问题需要进一步研究。尽管使用全髋关节置换术进行了急性治疗,但与对照组相比,髋部骨折患者在术后两年的步态模式发生了变化。这表明,这些变化是由植入物的存在或手术造成的部分软组织创伤引起的,而不是由接受选择性手术的患者存在的任何退行性疾病引起的:NCT04791605。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信