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In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
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Defining high activity in arthroplasty patients.

N B Robertson1, A K Battenberg1, M Kertzner2

  • 1Harbor UCLA Medical Center, 1000 W Carson St. Box 422, Torrance, California, 90509, USA.

The Bone & Joint Journal
|January 7, 2016
PubMed
Summary

Defining high activity after hip or knee replacement is crucial. This study proposes new metrics for highly active patients, showing no revisions in those exceeding 3 million gait cycles per year.

Keywords:
hip resurfacingpatient activitytotal hiptotal knee

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Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering
  • Sports medicine

Background:

  • High physical activity post-arthroplasty may increase revision risk.
  • The definition of 'highly active' in this context is not standardized.

Purpose of the Study:

  • To quantify physical activity levels in patients with active lifestyles after lower limb arthroplasty.
  • To propose objective definitions for 'high activity' based on measured data.

Main Methods:

  • Utilized a validated ankle accelerometer to measure activity in 13 patients (20 arthroplasties).
  • Assessed activity levels at a mean of 8.7 years post-operation.
  • Calculated gait cycles per day, per year, and percentage of time in high activity mode.

Main Results:

  • Mean activity: 8273 gait cycles/day, extrapolating to 3.0 million cycles/year (cpy).
  • Mean high activity: 4.3% of time (approx. 1 hour/day), representing 40% of total cycles.
  • Proposed definitions: >3 million cpy, 1 hour/day in high activity, or 40% of cycles in high activity.

Conclusions:

  • No revised arthroplasties or signs of impending failure were observed in this cohort.
  • The proposed definitions provide objective criteria for 'high activity' following lower limb arthroplasty.
  • Further research is warranted to correlate these activity levels with long-term implant survival.