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. 2008 Dec;466(12):3051-8.
doi: 10.1007/s11999-008-0488-9. Epub 2008 Sep 10.

Short-term recovery of balance control after total hip arthroplasty

Vipul Lugade  1 , Virginia Klausmeier, Brian Jewett, Dennis Collis, Li-Shan Chou
Affiliations

Short-term recovery of balance control after total hip arthroplasty

Vipul Lugade et al. Clin Orthop Relat Res. 2008 Dec.

Abstract

Hip osteoarthritis leads to chronic pain and deteriorated joint function, which affect weightbearing and balance during gait. THA effectively restores hip function but it is not known whether THA restores balance during gait. We hypothesized patients would have greater frontal plane and smaller sagittal plane center of mass-center of pressure inclination angles preoperatively compared with control subjects, and THA would improve these inclination angles by 16 weeks postsurgery. Compared with control subjects, we observed greater frontal plane inclination angles and smaller sagittal plane angles preoperatively, indicating gait imbalance. These inclination angles were improved postoperatively, providing better balance control. Despite improvement, patients differed in frontal and sagittal plane inclination angles compared with control subjects. This suggests residual deficits in dynamic balance control in patients undergoing THA before and up to 4 months after surgery.

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Figures

Fig. 1A–C
Fig. 1A–C
The CoM-CoP inclination angles in the (A) anterior (θA), (B) posterior (θP), and (C) medial (θM) directions are defined as angles formed by a line connecting the CoM and CoP, and a vertical line passing through the CoP.
Fig. 2A–B
Fig. 2A–B
The graph shows typical CoM-CoP inclination angles from left toe-off (LTO) to left heel strike (LHS) to right toe-off (RTO) to right heel strike (RHS) in (A) the sagittal and (B) frontal planes before and after THA.
Fig. 3A–C
Fig. 3A–C
Maximum (A) anterior, (B) posterior, and (C) medial CoM-CoP inclination angles are shown for the two subject groups. †At all times, the THA group displayed a smaller anterior inclination angle (p = 0.0004, 0.0002, and 0.0064, respectively) and greater medial inclination angle (p = 0.0006, 0.0167, and 0.0101, respectively) when compared with the control group, indicating decreased ability in balance control. The posterior inclination angle approached the level of control subjects by 16 weeks postsurgery (p = 0.0562), whereas it was smaller before surgery (p = 0.0012) and 6 weeks postsurgery (p = 0.0005). *Compared with presurgery, patients undergoing THA had a smaller medial inclination angle at 6 (p = 0.0078) and 16 (p = 0.0084) weeks and a greater posterior inclination angle (p = 0.0247) at 16 weeks postsurgery.
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