Adverse effects of total hip arthroplasty on the hip abductor and adductor muscle lengths and moment arms during gait

Background

Precise evaluation of the hip abductor and adductor muscles function in total hip arthroplasty (THA) patients during gait could help prevent postoperative complications and optimize the rehabilitation training program. The purpose of this study was to elucidate the effects of THA on the hip abductor and adductor muscle lengths and moment arms of in vivo patients during gait.

Methods

Ten unilateral THA patients received CT scans and dual fluoroscopic imaging for the hip kinematics during gait. The hip abductor and adductor muscle insertions were digitized on the 3D hip model for the determination of their dynamic lines of action and moment arms. Changes in the hip abductor and adductor muscle lengths and moment arms of THA patients between the implanted and non-implanted sides were quantified during gait.

Results

The adductor longus, adductor brevis, and pectineus of the implanted hips had significantly (P < 0.05) less elongation than that of the non-implanted side during the stance phase. The gluteus medius, gluteus minimus, and piriformis moment arms of the implanted side were significantly shorter. The piriformis muscle moment arm was significantly larger. In the double support phase, the adductor magnus and adductor longus moment arms of the implanted sides were significantly decreased.

Conclusions

Results suggested that the adverse effects of THA on hip stability. Development of a rehabilitation program considering the effects of THA is essential. Accurate surgical techniques may reduce the impact of THA on the peripheral muscles.