Sex-specific sagittal and frontal plane gait mechanics in persons post-hip arthroscopy for femoroacetabular impingement syndrome

Abstract

Postoperative gait mechanics in persons with femoroacetabular impingement syndrome (FAIS) remain understudied as a treatment outcome despite observed, yet inconclusive, preoperative gait abnormalities. Females with FAIS demonstrate worse preoperative patient-reported hip function and altered hip mechanics when compared with males; it is unknown whether these sex differences persist postarthroscopy. The purpose of this study was to compare sex-specific gait kinematics between persons at least 1 year postarthroscopy for FAIS and healthy comparisons. General linear models with estimating equations were used to evaluate the effect of (a) limb and sex within each group, and (b) limb and group within each sex for peak sagittal and frontal plane trunk, pelvis, and hip kinematics during stance phase of gait. Analyses were covaried by gait speed. Seventeen females and eight males an average 2.5 years postarthroscopy (1.1-7.2 year) for FAIS were compared with healthy females (n = 7) and males (n = 5). Females in the FAIS group presented with an average of 4.6° more anterior pelvic tilt, and 4.8° less hip extension compared with healthy females (P ≤ .03) and 8.6° less trunk flexion, 4.8° more anterior pelvic tilt, 3.1° more pelvic drop, and 7.5° more hip flexion than males with FAIS (P ≤ .03). Males in the FAIS group presented with 2.9° less pelvic drop, and 3.2° less hip adduction than healthy males. Preoperative gait mechanics were not collected and thus changes in mechanics could not be evaluated. This study is significant to clinicians who treat patients postarthroscopy to consider sex-specific gait impairments.

Keywords: FAI; gender; kinematics; walking.

Figure1.

Frontal plane pelvic position was described as hike or drop relative to the stance limb.

Figure2.

Schematic sagittal plane representation of relative joint positions of the trunk, pelvis, and lower extremity at peak hip extension for healthy cohort (A) and femoroacetabular impingement syndrome (FAIS) cohort (B). Group means for each joint position (trunk, pelvis, hip, knee, ankle) were obtained based on time-normalized data.

Figure3.

Schematic frontal plane representation of relative joint positions of the trunk, pelvis, and lower extremity at peak hip extension for healthy cohort (A) and femoroacetabular impingement syndrome (FAIS) cohort (B). Group means for each joint position (trunk, pelvis, hip, knee, ankle) were obtained based on time-normalized data.

Figure4.

Sagittal plane time series curves representing averages and standard error for females (red) and males (black) in the healthy and femoroacetabular impingement syndrome (FAIS) groups. Flex=Flexion, Ext=Extension, Post=Posterior, Ant=Anterior.

Figure5.

Frontal plane time series curves representing averages and standard error for females (red) and males (black) in the healthy and femoroacetabular impingement syndrome (FAIS) groups. Lateral trunk flexion is in relation to the ipsilateral or contralateral side of the stance limb. Ipsi=Ipsilateral, Contra=Contralateral, Add=Adduction, Abd=Abduction.