The effect of surgical change to hip geometry on hip biomechanics after primary total hip arthroplasty

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dc.contributor.authorBahl, J.S.
dc.contributor.authorArnold, J.B.
dc.contributor.authorSaxby, D.J.
dc.contributor.authorTaylor, M.
dc.contributor.authorSolomon, L.B.
dc.contributor.authorThewlis, D.
dc.date.issued2023
dc.descriptionPublished June 2023
dc.description.abstractThe aim of this study was to determine the effect of surgical change to the acetabular offset and femoral offset on the abductor muscle and hip contact forces after primary THA using computational methods. Thirty-five patients undergoing primary THA were recruited. Patients underwent a computed tomography scan of their pelvis and hip, and underwent gait analysis pre- and 6-months post-operatively. Surgically induced changes in acetabular and femoral offset were used to inform a musculoskeletal model to estimated abductor muscle and hip joint contact forces. Two experiments were performed: (1) influence of changes in hip geometry on hip biomechanics with preoperative kinematics; and (2) influence of changes in hip geometry on hip biomechanics with postoperative kinematics. Superior and medial placement of the hip centre of rotation during THA was most influential in reducing hip contact forces, predicting 63% of the variance (p<0.001). When comparing the preoperative geometry and kinematics model, with postoperative geometry and kinematics, hip contact forces increased after surgery (0.68 BW, p=0.001). Increasing the abductor lever arm reduced abductor muscle force by 28% (p<0.001) and resultant hip contact force by 17% (0.6 BW, p=0.003), with both preoperative and postoperative kinematics. Failure to increase abductor lever arm increased resultant hip contact force 11% (0.33 BW, p<0.001). In conclusion, increasing the abductor lever arm provides a substantial biomechanical benefit to reduce hip abductor and resultant hip joint contact forces. The magnitude of this effect is equivalent to the average increase in hip contact force seen with improved gait from pre-to post-surgery. This article is protected by copyright. All rights reserved.
dc.description.statementofresponsibilityJasvir S. Bahl, John B. Arnold, David J. Saxby, Mark Taylor, Lucian B. Solomon, Dominic Thewlis
dc.identifier.citationJournal of Orthopaedic Research, 2023; 41(6):1240-1247
dc.identifier.doi10.1002/jor.25455
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.urihttps://hdl.handle.net/2440/136801
dc.language.isoen
dc.publisherWiley
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1126229
dc.rights© 2022 The Authors. Journal of Orthopaedic Research® published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
dc.source.urihttps://doi.org/10.1002/jor.25455
dc.subjectHip biomechanics
dc.subjectHip geometry
dc.subjectmusculoskeletal model
dc.subjectsimulation
dc.titleThe effect of surgical change to hip geometry on hip biomechanics after primary total hip arthroplasty
dc.typeJournal article
pubs.publication-statusPublished

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