Three-dimensional gait of patients with developmental dysplasia of hip undergoing total hip arthroplasty with high hip center / 中国组织工程研究

ABSTRACT

BACKGROUND: For patients with Crowe II and III developmental dysplasia of hip combined with severe hip osteoarthritis, total hip arthroplasty is still controversial whether to choose acetabular anatomical reconstruction or high hip rotation center reconstruction. OBJECTIVE: To compare the differences in gait characteristics between the reconstruction technique of the high hip center and the anatomical hip center during total hip arthroplasty. METHODS: Forty patients with Crowe II-III developmental dysplasia of hip with unilateral hip disease from January 2014 to July 2017 were selected. All patients received total hip arthroplasty, of which 20 cases underwent acetabular anatomical reconstruction, and another 20 patients underwent high hip center reconstruction. The patients were followed up for more than 2 years after arthroplasty for gait analysis. The study was approved by Ethics Committee of Affiliated Hospital of Xuzhou Medical University. RESULTS AND CONCLUSION: (1) Spatiotemporal parameters The pace, stride frequency, step length, single leg support time, single leg swing time, and double leg support time of the two groups of surgical side and non-surgical side were similar. There was no significant difference in pace, stride frequency, step length, one-leg support time, one-leg swing time, and two-leg support time between the two groups (P > 0.05). (2) Kinematic parameters The maximum extension of the hip joint on the surgical side of the high reconstruction group was lower than that on the non-surgical side (P 0.05). (3) Kinetic parameters The longitudinal peak of the plantar reaction force on the surgical side of the high reconstruction group was higher than that of the anatomical reconstruction group (P 0.05). (4) The results show that in patients with developmental dysplasia of hip, total hip arthroplasty using high hip center reconstruction can obtain gait parameters similar to anatomical hip center reconstruction. However, compared with patients undergoing anatomical hip rotation center reconstruction, patients with high hip center reconstruction had limited hip flexion and extension range movement and greater longitudinal force on the hip.