FEATURES OF THE ABDUCTION MECHANISM WORK BEFORE AND AFTER TOTAL HIP JOINT ARTHROPLASTY
Clinical medicine

FEATURES OF THE ABDUCTION MECHANISM WORK BEFORE AND AFTER TOTAL HIP JOINT ARTHROPLASTY

Published 2020-06-24

Authors:

O.A. Tyazhelov
O.D. Karpinska
L.D. Goncharova
F.V. Klymovytskyi

Abstract:
Increased tone of the flexors and adductor muscles of the hip in combination with a decrease in elasticity and contractile function of abductors and protractors of the hip due to contracture of the hip joint leads to imbalance in the muscles of the pelvic girdle, which negatively affects the positional adaptation of endoprosthesis components during the surgery and complicates the postoperative period in patients. The treatment results analysis of 114 patients with diseases of the hip joint showed that in most patients the manifestations of pelvic girdle muscle deficiency after hip arthroplasty decreased, but did not disappear for a long time. The study of vertical posture in patients with normal and reduced size of the total femoral offset after hip arthroplasty showed that the reduction of the abductor shoulder leads to a significant change in the main indices of the stabilogram, namely to increased energy expenditure to maintain vertical posture, therefore energy depletion occurs faster. It is clinically manifested by symptoms of pelvic girdle muscle insufficiency - lameness, positive symptom of Trendelenburg, Duchenne, the need to use additional support, etc.
Keywords:
endoprosthetics hip joint vertical posture statography femoral offset
References:
  1. Loskutov AYe. Endoprotezirovaniye tazobedrennogo sustava: monografiya. Dnepropetrovsk: Lira, 2010. 344 s. [in Russian]
  2. Yanson KA. Biomekhanika nizhney konechnosti cheloveka. Riga: Zinatne, 1975. [in Russian]
  3. Beaulieu ML, Lamontagne M, Beaulé PE. (). Lower limb biomechanics during gait do not return to normal following total hip arthroplasty. Gait & Posture. 2010; 32(2), 269-273. doi:10.1016/j.gaitpost.2010.05.007
  4. Clement ND, Patrick-Patel RS,MacDonald D, Breusch SJ. Total hip replacement: increasing femoral offset improves functional outcome. Arch Orthop Trauma Surg. 2016; 136: 1317–1323. doi: 10.1007/s00402-016-2527-4
  5. Eltorai AEM, Daniels AH, Jenkins DR, Rubin LE. Hip Replacement: Experts Answer Your Questions. JHU Press. 2019: 160.
  6. Harris WH. Traumatic Arthritis of the Hip after Dislocation and Acetabular Fractures. The Journal of Bone & Joint Surgery. 1969; 51(4): 737-755. doi:10.2106/00004623-196951040-0001
  7. Kizilova N, Karpinsky M, Karpinska E. Quasi-regular and chaotic dynamics of postural sway in human. Applied Non-Linear Dynamical Systems. Jan Awrejcewicz (ed). Springer Proceedings in Mathematics & Statistics. 2014; 93: 103-114. DOI: 10.1007/978-3-319-08266-0_8
  8. Lamontagne M, Beaulieu ML, Beaulé PL. Erratum: Comparison of joint mechanics of both lower limbs of THA patients with healthy participants during stair ascent and descent. Journal of Orthopaedic Research. 2011; 29(9): 1457-1457. doi:10.1002/jor.21472
  9. Mahmood SS, Mukka SS, Crnalic S, Wretenberg P, Sayed-Noor AS. Association between changes in global femoral offset after total hip arthroplasty and function, quality of life, and abductor muscle strength. Acta Orthopaedica. 2015; 87(1): 36-41. doi:10.3109/17453674.2015.1091955
  10. Rüdiger H, Guillemin M, Latypova A, Terrier A. Effect of changes of femoral offset on abductor and joint reaction forces in total hip arthroplasty. Archives of Orthopaedic and Trauma Surgery. 2017; 137(11): 1579–1585. DOI: 10.1007/s00402-017-2788-6
  11. Tyazhelov OA, Karpinsky MY, Karpinskaya OD, Goncharova LD, Klimovitsky RV, Fishchenko VO. Clinical and biomechanical substantiation and modeling work of the muscles supporting horizontal balance of the pelvis. Trauma. 2017; 18 (5): 13-18. DOI: 10.22141/1608-1706.5.18.2017.114115
  12. Vissers MM, Bussmann JB, Verhaar JAN, Arends LR, Furlan AD, Reijman M. Recovery of Physical Functioning After Total Hip Arthroplasty: Systematic Review and Meta-Analysis of the Literature. Physical Therapy. 2011;91 (5): 615–629. doi.org/10.2522/ptj.20100201
Publication:
«World of Medicine and Biology» Vol. 16 No. 73 (2020) , с. 134-139
УДК 616.728.2-089.28:612.76