Altered gait mechanics are associated with severity of chondropathy after hip arthroscopy for femoroacetabular impingement syndrome.
Adolescent
Adult
Arthroscopy
Biomechanical Phenomena
Cartilage, Articular
/ pathology
Case-Control Studies
Cross-Sectional Studies
Female
Femoracetabular Impingement
/ pathology
Gait
/ physiology
Hip Joint
/ pathology
Humans
Male
Middle Aged
Postoperative Period
Severity of Illness Index
Treatment Outcome
Young Adult
Loading response
Post-operative
Total support
Walking
Journal
Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
26
02
2019
revised:
31
10
2019
accepted:
05
11
2019
pubmed:
12
2
2020
medline:
12
11
2020
entrez:
12
2
2020
Statut:
ppublish
Résumé
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. Do sagittal plane gait mechanics differ based on chondropathy severity following arthroscopy for FAIS? 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. 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). 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.
Sections du résumé
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.
Identifiants
pubmed: 32044697
pii: S0966-6362(19)30205-X
doi: 10.1016/j.gaitpost.2019.11.003
pmc: PMC7138257
mid: NIHMS1562255
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
175-181Subventions
Organisme : NCATS NIH HHS
ID : KL2 TR001068
Pays : United States
Organisme : NCATS NIH HHS
ID : TL1 TR002735
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000090
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002733
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : ErratumIn
Type : CommentIn
Informations de copyright
Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.
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