Tag: Zmiany zwyrodnieniowe stawu biodrowego

A biomechanical analysis of gait disturbances in a patient following alloplasty of the hip joint

Wiesław Chwała, Witold Serafin, Anna Marchewka

Wiesław Chwała, Witold Serafin, Anna Marchewka – A biomechanical analysis of gait disturbances in a patient following alloplasty of the hip joint. Fizjoterapia Polska 2007; 7(2), 185-197

Abstract

Background. The physical examination and imaging studies are the diagnostic tools of today’s therapists and physicians. The drawbacks of these methods include a lack of objectivity as the assessment depends on the examiner’s clinical experience and the limited possibilities of the physical examination. As attention is quite often focused on a specific clinical area, biomechanical relations with other structures in the locomotor system are neglected. Three-dimensional analysis of movement is now available to clinicians as a new method of analysis of patient locomotion that can ensure a holistic and precise whole-body diagnosis of biomechanical disturbances. Material and methods. A three-dimensional gait analysis was carried out at the Laboratory of Biokinetics of the University of Physical Education in Cracow, Poland. A 56 year-old woman with right hip coxarthrosis underwent an examination of locomotion before an elective THR at the Department of Neuroorthopedics of the Rydygier Hospital in Cracow, and four months after the sur-gical procedure, following a period of total unloading of the operated right hip, around the time she commenced unsupported ambulation without assistive forearm crutches. Results and Conclusions. Based on the three-dimensional analysis of motion, a number of gait disturbances were detected which had originated from the degenerative changes within the hip joint and were not noticed during the physical examination. A comparison of the pre- and post-operative data showed that the pathologic gait patterns were successfully altered thanks to THR. Specifically, the range of motion within the hip joint was closer to relevant biomechanical reference values. The results of the postoperative examination suggest the presence of persistent disturbances of muscle function that still necessitate compensatory work of the contralateral limb.

Key words:

three-dimensional gait analysis, coxarthrosis, THR

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The Evolution of Index of Stability and Controlled Balance in Patients After Alloplastic Surgery of the Hip Joint in the Early Postoperative Period

Rafał Pluszyński, Artur Walczak

R. Pluszyński, A. Walczak – The Evolution of Index of Stability and Controlled Balance in Patients After Alloplastic Surgery of the Hip Joint in the Early Postoperative Period. FP 2016;16(4);98-115

Abstract

Background.Degenerative disorders of the hip joint are one of the most common causes of pain in patients in middle and old ages. In addition to pain, there occurs reduced activity and quality of life in the areas of psychology, social relations and physical fitness.
Aim of the study. In this work we have made an attempt to analyze the evolution of static postural stability in patients after the alloplastic hip joint surgery. The aim of the study was to evaluate the change of the center of gravity of the body in patients after the treatment.
Material and methods. The research has been carried out in SPSZOZ Municipal Hospital in Elblag, in the Department of Trauma and Orthopedic Surgery. For the stabilographic examinations we used the BIODEX balance platform.
The examinations were carried out twice, fist time before the alloplastic procedure, and second time on the last of the patient’s stay in hospital (usually it would be 6th-7th day). The examination involved the patients standing naturally in vertical position, on the whole feet and with open eyes. There were 3 attempts, each lasting 20 seconds. In the study participated 85 persons.
Results. 1. In all the measurements, ie. in the overall result, the indicators A/P and M/L, percentage of time with the load on the particular zones and quadrants, there were no significant differences between the indicators before and after the surgical treatment. The study participants similarly functioned during the tests both, before and after the surgical procedure. 2. Before the surgery worse overall result obtained men than women. Persons with left side coxarthrosis obtained worse result in the indicator M/L than persons with right side coxarthrosis, which indicate greater asymmetry of the pelvis, in M/L plane, in patients with left side coxarthrosis. 3. After the surgery worse overall result obtained women than men. Women also obtained worse results in terms A/P and M/L indicators, than men. 4. Both, before and after the surgery, the overall worse results were obtained by shorter patients, in comparison to those who were taller. After the surgery, worse results obtained shorter persons in the A/P and M/L indicators.
5. After the surgery value of the indicator M/L changed to statistically insignificant, which suggests, that after the surgery position of pelvis improved in the frontal plane, in the examined patients,. 6. After the surgery, the taller persons have smaller deviations from their center of gravity. 7. The analysis showed, that along with the growing age of the patients, also grows the indicator of the percentage of time in zone C, which indicates a_significant deviation from the axis of the body.

Keywords:

degenerative disorders of the hip joint, index of stability, alloplastic surgery of the hip joint

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