Kinematic pelvic tilt during gait alters functional cup position in total hip arthroplasty

  • Static pelvic tilt impacts functional cup position in total hip arthroplasty (THA). In the current study we investigated the effect of kinematic pelvic changes on cup position. In the course of a prospective controlled trial postoperative 3D-computed tomography (CT) and gait analysis before and 6 and 12 months after THA were obtained in 60 patients. Kinematic pelvic motion during gait was measured using Anybody Modeling System. By fusion with 3D-CT, the impact of kinematic pelvic tilt alterations on cup anteversion and inclination was calculated. Furthermore, risk factors correlating with high pelvic mobility were evaluated. During gait a high pelvic range of motion up to 15.6° exceeding 5° in 61.7% (37/60) of patients before THA was found. After surgery, the pelvis tilted posteriorly by a mean of 4.0 ± 6.6° (p < .001). The pelvic anteflexion led to a mean decrease of −1.9 ± 2.2° (p < .001) for cup inclination and −15.1 ± 6.1° (p < .001) for anteversion in relation to the anterior pelvic plane (APP). Kinematic pelvic changes resulted in a further change up to 2.3° for inclination and up to 12.3° for anteversion. In relation to the preoperative situation differences in postoperative cup position ranged from −4.4 to 4.6° for inclination and from −7.8 to 17.9° for anteversion, respectively. Female sex (p < .001) and normal body weight (p < .001) correlated with high alterations in pelvic tilt. Kinematic pelvic changes highly impact cup anteversion in THA. Surgeons using the APP as reference should aim for a higher anteversion of about 15° due to the functional anteflexion of the pelvis during gait.

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Author:Markus Weber, Franz Suess, Seth Jerabek, Matthias Meyer, Joachim GrifkaORCiD, Tobias Renkawitz, Sebastian DendorferORCiD
Parent Title (English):Journal of Orthopaedic Research
Document Type:Article
Year of first Publication:2021
Release Date:2021/06/15
Tag:component position; gait analysis; kinematics; pelvic tilt; total hip arthroplasty
GND Keyword:Hüftgelenkprothese; Haltungsfehler; Hüftgelenkpfanne
First Page:846
Last Page:853
Institutes:Fakultät Maschinenbau
Regensburg Center of Biomedical Engineering - RCBE
Fakultät Maschinenbau / Labor Biomechanik (LBM)
research focus:Lebenswissenschaften und Ethik
OpenAccess Publikationsweg:Hybrid Open Access - OA-Veröffentlichung in einer Subskriptionszeitschrift/-medium
Licence (German):Creative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International