Lower functioning patients demonstrate atypical hip joint loading before and following total hip arthroplasty for osteoarthritis

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dc.contributor.authorBahl, J.S.
dc.contributor.authorArnold, J.B.
dc.contributor.authorTaylor, M.
dc.contributor.authorSolomon, L.B.
dc.contributor.authorThewlis, D.
dc.date.issued2020
dc.description.abstractPrevious studies have established that up to one year post a total hip arthroplasty (THA), patients do not recover normal function and the magnitude of hip joint loading remains reduced compared to healthy individuals. However, the temporal nature of the loading profile has not been considered to identify individuals who are at a greater risk of poor functional outcomes following THA. This study aimed to determine the changes to the profile and magnitude of the resultant hip joint reaction force before and up to six months post primary THA, and factors associated with atypical loading profiles. Hip joint loading was computed using a personalised lower-limb musculoskeletal model in 43 participants awaiting primary THA for osteoarthritis (mean age: 65 SD 14 years; BMI: 30 SD 5 kg/m2 ) before and up to 6 months after THA. Atypical, single peak loading profiles were observed for 11 patients before surgery, where four showed a single peak at 6 months. Patients displaying a single peak profile walked slower (mean difference: -0.4 m·s-1 ) compared to individuals displaying double peak profile (p = <.001) and had significantly reduced sagittal plane hip range of motion during gait (mean difference -9.6 degrees, p = <.001). Self-reported pain, function and stiffness did not differentiate between patients with a single or double peak loading profile. Individuals with a single peak force profile did not meet the minimal clinically important hip range of motion during gait and would be classified as low functioning THA patients. CLINICAL RELEVANCE: The temporal nature of the force profile may help to identify individuals who are at the greatest risk of poor functional outcomes after a THA. This article is protected by copyright. All rights reserved.
dc.description.statementofresponsibilityJasvir S. Bahl, John B. Arnold, Mark Taylor, Lucian B. Solomon, Dominic Thewlis
dc.identifier.citationJournal of Orthopaedic Research, 2020; 38(7):1550-1558
dc.identifier.doi10.1002/jor.24716
dc.identifier.issn0736-0266
dc.identifier.issn1554-527X
dc.identifier.orcidBahl, J.S. [0000-0002-3267-0098]
dc.identifier.orcidArnold, J.B. [0000-0002-1158-8917]
dc.identifier.orcidSolomon, L.B. [0000-0001-6254-2372]
dc.identifier.orcidThewlis, D. [0000-0001-6614-8663]
dc.identifier.urihttp://hdl.handle.net/2440/126225
dc.language.isoen
dc.publisherWiley
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1120560
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1126229
dc.rights© 2020 Orthopaedic Research Society. Published by Wiley Periodicals LLC.
dc.source.urihttps://doi.org/10.1002/jor.24716
dc.subjectHip reaction force
dc.subjectOpenSim
dc.subjectfunction
dc.subjectmusculoskeletal modelling
dc.subjectosteoarthritis
dc.subjecttotal hip arthroplasty
dc.titleLower functioning patients demonstrate atypical hip joint loading before and following total hip arthroplasty for osteoarthritis
dc.typeJournal article
pubs.publication-statusPublished

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