The authors declare that they have no competing interests.
SK conceptualized the study, prepared the study, performed the measurements, performed data analysis, interpreted findings, drafted the manuscript. RF performed data analysis, interpreted findings, aided in drafting the manuscript. JL prepared the study, performed the measurements, interpreted findings, aided in drafting the manuscript. PJCH prepared the study, interpreted findings, aided in drafting the manuscript. ACHG interpreted findings, aided in drafting the manuscript. NV conceptualized the study, interpreted findings, aided in drafting the manuscript. VW conceptualized the study, performed data analysis, interpreted findings, aided in drafting the manuscript. All authors read and approved the final manuscript.
In adult patients with developmental hip dysplasia, a surgical procedure (triple innominate osteotomy) of the pelvic bone can be performed to rotate the acetabulum in the frontal plane, establishing better acetabular coverage. Although common clinical hip scores demonstrate significant improvements after surgery, they provide only overall information about function. The purpose of this study was to quantify the long-term outcome of triple innominate osteotomy in more detail using gait analyses and muscle strength measurements.
We performed gait analyses at self-selected walking speed as well as isometric hip and knee muscle strength tests in twelve women who had undergone a unilateral triple innominate osteotomy (age: 34 ± 12 y, time post surgery: 80 ± 18 m). We compared the results to reference values obtained from eight healthy peers (age: 33 ± 10 y).
The patients exhibited slight asymmetries in step length (smaller steps) and stance time (longer stance) as well as lower hip abduction moments in the operated limb in early stance compared to the non-operated limb. However, there were no differences in gait compared to healthy controls, even though the patients showed reduced bilateral hip abduction strength compared to controls.
Our results indicate that the patients’ gait pattern had generally recovered very well, despite slight asymmetries in spatiotemporal parameters. Subtle deviations in hip abduction moments were observed during gait, whereas hip abduction strength was substantially reduced. Hence, the patients walked at a higher percentage of their maximal capacity. They may, therefore, be prone to fatigue and adopt compensatory gait strategies more quickly than healthy peers when walking long distances.
Hsin J, Saluja R, Eilert RE, Wiedel JD. Evaluation of the biomechanics of the hip following a triple osteotomy of the innominate bone. J Bone Joint Surg Am. 1996;78(6):855–62. PubMed
Steel HH. Triple osteotomy of the innominate bone. J Bone Joint Surg Am. 1973;55(2):343–50. PubMed
Kolk S, Minten MJ, van Bon GE, Rijnen WH, Geurts AC, Verdonschot N, et al. Gait and gait-related activities of daily living after total hip arthroplasty: a systematic review. Clin Biomech (Bristol, Avon). 2014;29(6):705–18. CrossRef
Lin DH, Jan MH, Liu TK, Lin YF, Hou SM. Effects of anterolateral minimally invasive surgery in total hip arthroplasty on hip muscle strength, walking speed, and functional score. J Arthrop. 2007;22(8):1187–92. CrossRef
Ganz R, Klaue K, Vinh TS, Mast JW. A new periacetabular osteotomy for the treatment of hip dysplasias. Technique and preliminary results. Clin Orthop Relat Res. 1988;232:26–36. PubMed
Kooijman MA, Pavlov PW. Triple osteotomy of the pelvis. A review of 51 cases. Clin Orthop Relat Res. 1990;255:133–7. PubMed
Dawson J, Fitzpatrick R, Carr A, Murray D. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br. 1996;78(2):185–90. PubMed
Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51(4):737–55. PubMed
Klein Horsman MD, Koopman HF, van der Helm FC, Prose LP, Veeger HE. Morphological muscle and joint parameters for musculoskeletal modelling of the lower extremity. Clin Biomech (Bristol, Avon). 2007;22(2):239–47. CrossRef
Winter DA. The biomechanics and motor control of human movement: Normal, elderly and pathological. Canada: University of Waterloo Press; 1991.
Andersen MS, Damsgaard M, MacWilliams B, Rasmussen J. A computationally efficient optimisation-based method for parameter identification of kinematically determinate and over-determinate biomechanical systems. Comp Meth Biomech Biomed Eng. 2010;13(2):171–83. CrossRef
Damsgaard M, Rasmussen J, Christensen ST, Surma E, de Zee M. Analysis of musculoskeletal systems in the AnyBody Modeling System. Simul Mod Pract Theory. 2006;14(8):1100–11. CrossRef
Wu G, Siegler S, Allard P, Kirtley C, Leardini A, Rosenbaum D, et al. ISB recommendation on definitions of joint coordinate system of various joints for the reporting of human joint motion–part I: ankle, hip, and spine. International Society of Biomechanics. J Biomech. 2002;35(4):543–8. CrossRefPubMed
Romano CL, Frigo C, Randelli G, Pedotti A. Analysis of the gait of adults who had residua of congenital dysplasia of the hip. J Bone Joint Surg Am. 1996;78(10):1468–79. PubMed
- Gait and lower limb muscle strength in women after triple innominate osteotomy
Petra JC Heesterbeek
Alexander CH Geurts
- BioMed Central
Neu im Fachgebiet Orthopädie und Unfallchirurgie
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