RESUMO
The purpose of this article is to determine if individuals with high rather than low femoral offset of a total hip arthroplasty achieve improved hip abductor muscle strength and thus improved their ability to step over an obstacle safely. These outcomes will help surgeons decide whether increasing the femoral offset helps a patient's physical function.
Assuntos
Artroplastia de Quadril/métodos , Prótese de Quadril , Força Muscular , Osteoartrite do Quadril/fisiopatologia , Fêmur/cirurgia , Marcha , Articulação do Quadril/fisiopatologia , Humanos , Músculo Esquelético/fisiopatologia , Músculo Esquelético/cirurgia , Osteoartrite do Quadril/cirurgia , Amplitude de Movimento Articular/fisiologiaRESUMO
BACKGROUND: Compared to the design of a traditional multi-axis total knee arthroplasty, the single-axis arthroplasty studied has a fixed flexion/extension center of rotation in the femoral component. The influence of this characteristic on functional daily activity, i.e., stand-to-sit, is not well understood. The purpose of this study was to investigate the effect of different arthroplasty designs on knee kinematic and lower limb muscular activation for the stand-to-sit movement. METHODS: Sixteen unilateral, posterior-stabilized knee arthroplasty participants (8 single-axis and 8 multi-axis) with excellent Knee Society scores performed 4 trials of the stand-to-sit test. Three-dimensional video analysis of whole body and joint kinematics and electromyography analysis of quadriceps and hamstrings were conducted. One-way ANOVAs were used for statistical analyses (alpha=0.05). FINDINGS: The multi-axis group showed some functional adaptations while sitting down. The single-axis group exhibited less arthroplasty limb quadriceps electromyography and hamstring co-activation electromyography than the multi-axis group. For the arthroplasty limb, single-axis demonstrated less abduction angular displacement and reached peak abduction earlier than the multi-axis arthroplasty limb. The estimated effect size for this study was 0.196. INTERPRETATION: The single-axis design requires less eccentric knee extensor muscle activation and exhibits greater medio-lateral stability than the multi-axis designs. Findings from this study could provide useful information to orthopedic knee surgeons and rehabilitative specialists.