Importance of Proprioception After Total Hip Replacement

Á. Illyés, G. Holnapy, M. Szendrői, and R.M. Kiss (Hungary)


Biomechanics, kinematics, hip joint, propriopception, damping time


The biomechanical analysis of the lower extremity is common. It generally involves gait analysis, measuring the kinematic and kinetic parameters of gait. The aim of our study is to find a reproductive, precise, dynamic measuring method, which is able to analyze the proprioception of the lower limb during gait and to observe the effect of different operative methods for THR. 49 patients (35 females, 14 males) with unilateral primary osteoarthritis (OA) of the hip joint were selected for our study. The patients were divided into four groups (traditional antero-lateral and direct-lateral approach, minimalized posterior and minimalized direct-lateral approach) and according to the implantation technique of prostheses. Proprioception was examined by a Zebris CMS10 ultrasound-based measuring system, connected to a Zebris Posturomed device, which is a movable and adjustable plate. The patients were examined by the preformed tests of the Zebris WinPosture software such as the ‘Provocation test’, ’Stepping test’, ’Lower extremity test’, and ’Pelvis-shoulder test’ before operation, and on the 2nd , 6th , and 12th weeks after operation, both in a fixed and a moving examining plate. Investigated parameters include damping time, elevation of knee joint, pelvis and shoulder rotation. On the basis of the results it could be established that our ultrasound-based dynamic measuring system was able to perform reproducible measurements of proprioception. This measuring method is able to detect the effect of different THR implantation techniques on proprioception. On the 2nd postoperative week the biomechanical parameters are significantly less in patients operated with the capsule retaining technique, even when standing on both lower limbs and on the operated limb as well. This is due to the undeveloped proprioception of capsule extirpated patients.

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