Gait analysis in Patients with Coxa Valga after Pelvic Osteotomy for Unilateral Developmental Dysplasia of the Hip During Level Walking
Date Issued
2014
Date
2014
Author(s)
Chen, Ching-Ru
Abstract
Therapeutic use of pelvic osteotomy in developmental hip dysplasia abnormalities (DDH) is thought to prevent avascular necrosis, acetabular dysplasia, degenerative arthritis and other serious complications. While pelvic osteotomy can re-orient the acetabulum or change the acetabular capacity with alternated coverage direction to get a better hip geometry and location. It’s widely used in the early treatment of DDH. However, previous studies show there is a higher chance of developing hip avascular necrosis and premature osteoarthritis after pelvic osteotomy. Scholars have confirmed such complications were closely related to abnormal loadings at hip joint while walking. Therefore, it is very important to reduce joint reaction forces while restoring the normal geometric shape and functions of the hip joint in order to prevent degenerative diseases. Moreover, the femoral neck shaft angle often gradually increase with age in developmental hip dysplasia patients. Even after pelvic osteotomy, 8% of patients still suffer from coxa valga. Worsening hip valgus angle may result in asymmetric gait pattern, different muscle contraction pattern and maybe more energy consumption. Otherwise, it was proposed by other scholars that different hip valgus angles are highly correlated to different magnitudes and directions of joint force.
Therefore, the starting point of this study is to understand the differences of gait patterns in patients with coxa valga, normal femoral neck-shaft angle and normal control after pelvic osteotomy. Twenty-four females who had received pelvic osteotomy for unilateral DDH were recruited, twelve of them was classified as normal neck-shaft angle group(Average age:12.63y/o，average height:149.71cm，average body weight:41.9kg、(Body mass index, BMI):18.60), others are classified as coxa valga group(Average age:11.51y/o，average body height:144.91cm，average weight: 38.95kg、BMI:18.34) ,and Twelve age-matched healthy controls(Average age: 12.5y/o，average height: 148.7cm，average weight 41kg， BMI:24.29) were recruited. Three-dimensional motion analysis is used to analyze kinematic parameters such as joint angles and kinetic parameters like joint axial forces, ground reaction forces, loading rate and unloading rate of axial joint forces and ground reaction force, joint moments, etc. Spatial-temporal parameters are also included. These parameters may help us to understand the movement characteristics, action strategies, and compensatory action performance in different groups of patients during level walking. Results show that normal neck-shaft angle group has more pelvis anterior tilt, affected side hiking and bilateral knee flexion. Coxa valga group has more pelvis anterior tilt, affected side hiking and pelvis rotation to contralateral side. Peak joint axial force has significant increase in both hip and knee joints of affected side were also found in coxa valga group. Affected side soreness and muscle weakness are always complained by patients, therefore, different treatment strategies should be considered for different group to prevent common sequelae such as avascular necrosis and premature osteoarthritis of patients after pelvic osteotomy.
Subjects
骨盆切骨術
髖外翻
股頸幹角
早發性退化性關節炎
三維動作分析
SDGs
Type
thesis
File(s)![Thumbnail Image]()
Loading...
Name
ntu-103-R00548051-1.pdf
Size
23.54 KB
Format
Adobe PDF
Checksum
(MD5):b2b301fc5402ead6bdf5da59d752b58c