Gait analysis in a matched cohort short versus conventional stems in total hip replacement, is there a measurable difference?
Sheryl de Waard (Xpert Clinics)
I. N. Sierevelt (Xpert Clinics, Spaarne Gasthuis, Hoofddorp)
Marjolein Booij (Vrije Universiteit Amsterdam)
Jaap Harlaar (TU Delft - Biomechatronics & Human-Machine Control)
D. Haverkamp (Xpert Clinics)
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Abstract
Introduction: By means of gait analysis and EMG measurements, we evaluated the difference between short and conventional hip stems in patients who underwent hip replacement for osteoarthritis. The remaining gait differences after hip replacements are well documented and caused by many factors, among which offset restoration is an important factor. Based on the theory that short stems are more capable of restoring offset, we compared gait between short stems and conventional stems. Methods: Two groups of ten patients were selected from ongoing trials and were case matched. For all patients, a detailed gait and EMG measurement was performed using the GRAIL (Gait Real-time Analysis Interactive lab, Motek ForceLink BV, Netherlands) system. Our primary outcome measurement was the peak hip abduction moment (HAM). Other gait parameters, muscular activity and the hip disability and osteoarthritis outcome score (HOOS) were secondary outcome measurements. Results: The peak HAM for the short stems was 1.29 Nm/kg (0.27) compared to 1.14 Nm/kg (0.32) for the conventional stem group (not significant). The short-stem group further showed longer step and stride length. Gluteus medius activation needed to stabilize the trunk and walking speed did not reach significance. The HOOS was better in the short-stem group. Conclusion: The results of our pilot study support the belief that a short stem can result in better outcomes, as measured by gait and EMG analysis.
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