Highlights
- •In vivo load measurements with instrumented hip implants were performed at 3 and 50 months postoperatively.
- •Individual CT analyses of the gluteal muscle status and fat ratio were performed at 3 and 50 months postoperatively.
- •The individual muscle status are influence the postoperative hip joint loading.
- •Our findings suggest that an impairment of periarticular musculature contributes to an increase of the in vivo joint loads.
Abstract
Background
Hip joint loading is dominated by muscular activity. Thus, contact forces exceeding
many times one's body weight are a consequence of imbalanced muscular activity. The
objective was to analyze the influence of muscle atrophy after total hip arthroplasty
on in vivo hip joint contact loading initially and long term. We hypothesized that
an impaired periarticular muscle will lead to increase in vivo joint load, specifically
in the long term.
Methods
Using a group of nine patients with instrumented hip implants, contact forces and
muscle status were analyzed one day prior to 3 and 50 months after joint arthroplasty.
In vivo load measurements were performed for different activities of daily living
(ADL). Pre- and postoperative pelvic CT scans were analyzed to assess the periarticular
muscle status. Finally, the muscle morphologies and in vivo contact forces were compared.
Results
At 3 months after total hip arthroplasty we found a significant correlation of lower
lean gluteus minimus muscle (GMin) volume with higher loads during all tested activities
of daily living. 50 months postoperatively statistical analysis revealed lower lean
volume of the gluteus maximus to be correlated with higher joint loads in walking.
Conclusion
Our data generally show a good comparability between muscle status and joint contact
forces and thus support our hypothesis that an impairment of periarticular musculature
contributes to an increase of the in vivo joint loads after total hip arthroplasty.
Effects were most pronounced during stair climbing and sit-down/stand-up from a chair
at 3 months and during level walking at 50 months.
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Article info
Publication history
Published online: April 13, 2019
Accepted:
April 12,
2019
Received:
February 15,
2019
Identification
Copyright
© 2019 Elsevier Ltd. All rights reserved.
