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. 2020 Mar:77:175-181.
doi: 10.1016/j.gaitpost.2019.11.003. Epub 2019 Nov 11.

Altered gait mechanics are associated with severity of chondropathy after hip arthroscopy for femoroacetabular impingement syndrome

Lindsey Brown-Taylor  1 , Jordan Wilson  2 , Michael McNally  3 , Jennifer Perry  4 , Rebecca D Jackson  5 , Timothy E Hewett  6 , John Ryan  7 , Michael V Knopp  8 , Jason E Payne  8 , Stephanie Di Stasi  9
Affiliations

Altered gait mechanics are associated with severity of chondropathy after hip arthroscopy for femoroacetabular impingement syndrome

Lindsey Brown-Taylor et al. Gait Posture. 2020 Mar.

Erratum in

Abstract

Background: Suboptimal patient-reported function and movement impairments often persist after hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Individuals with FAIS with preoperative cartilage pathology (ie. chondropathy) demonstrate distinct movement patterns and have worse post-operative outcomes. It is unknown whether the presence of chondropathy after surgery negatively affects movement and function.

Research question: Do sagittal plane gait mechanics differ based on chondropathy severity following arthroscopy for FAIS?

Methods: A cross-sectional walking gait analysis was performed for 25 participants post-arthroscopy (2.48 ± 1.38y) and 12 healthy controls (HCs). Peak total support moment (TSM) and relative contributions of the hip, knee, and ankle were calculated during loading response. The Hip Osteoarthritis MRI Scoring System was used to categorize the FAIS group into no-mild or moderate-severe chondropathy groups based on 3 T magnetic resonance imaging of their surgical hip. The interactions of group by limb were evaluated for kinetic variables, covaried by gait speed.

Results: Groups did not differ based on age, BMI and sex distribution (P ≥ 0.14). 13 participants with FAIS presented with moderate-severe chondropathy and 12 presented with no-mild chondropathy. Participants with moderate-severe chondropathy walked significantly slower than both other groups (P = 0.006) and demonstrated lower peak TSM than those with no-mild chondropathy (P = 0.002). Participants with no-mild chondropathy demonstrated lower hip (61.5 %) and greater ankle (17.7 %) contributions to the TSM on the involved limb compared to the moderate-severe group (hip:73.4 %, P = 0.07; ankle:10.5 %, P = 0.007).

Significance: Slower gait speed alone did not explain the lower TSM strategy in participants with moderate-severe chondropathy. Interestingly, the joint contribution strategy of this group was not different than HCs. Participants with no-mild chondropathy demonstrated a TSM strategy that shifted the demand away from their hip and toward their ankle. Given the small sample size, and large variability in joint strategies, future work needs to examine whether these alterations in gait strategy, with or without advanced chondropathy, impact patient function.

Keywords: Loading response; Post-operative; Total support; Walking.

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Conflict of interest statement

Declaration of Competing Interest None.

Figures

Figure 1.
Figure 1.
Marker Placement
Figure 2.
Figure 2.
Time Series Gait Curves Time-normalized lower extremity moments and total support moment (TSM) are presented as group averages with standard error of the mean. Participants in the FAIS group are grouped by moderate-severe (MOD-SEV) or no-mild chondropathy.
Figure 3.
Figure 3.
Joint Contributions to Total Support Moment Dom= dominant limb; ND= nondominant limb; Inv= involved limb; Un= uninvolved limb; HC= healthy controls; No-Mild= No-mild chondropathy post-arthroscopy for femoroacetabular impingement syndrome; Mod-Sev= moderate-severe chonropathy post-arthroscopy for femoroacetabular impingement syndrome
See this image and copyright information in PMC

Comment in

References

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