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Do 3-dimensional Spinopelvic Characteristics Normalize After THA? A Prospective, Comparative Study Using Motion

Nicholas S Ryan¹, Erik Kowalski¹, Stephanie Antoniades²

¹The University of Ottawa, Human Movement Biomechanics Laboratory, Ottawa, ON, Canada.

Clinical Orthopaedics and Related Research

|September 3, 2024

Summary

Total hip arthroplasty (THA) improves spinopelvic motion, normalizing movement in sagittal, coronal, and axial planes during daily activities. This dynamic normalization suggests potential for improved patient outcomes and reduced dislocation risk post-surgery.

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Area of Science:

Orthopedic surgery
Biomechanics
Motion analysis

Background:

Spinopelvic stiffness is linked to poor outcomes and dislocation risk after total hip arthroplasty (THA).
Preoperative spinopelvic characteristics may inform patient-specific surgical planning for cup orientation.
Previous studies show sagittal plane normalization post-THA in static postures, but dynamic normalization remains unclear.

Purpose of the Study:

To investigate dynamic spinopelvic motion normalization after THA using motion capture.
To determine if normalization extends to coronal and axial planes during dynamic tasks.

Main Methods:

3D motion capture assessed spinal, pelvic, and hip motion in 15 THA patients (pre- and post-op) and 9 controls.
Tasks included seated bend and reach, seated trunk rotation, and gait.
Statistical parametric mapping (SPM) analyzed gait timing, comparing pre- vs. post-THA and patient vs. control groups.

Main Results:

THA patients showed significant improvements in sagittal spinal, pelvic, and hip range of motion (ROM) during seated bend and reach.
Sagittal hip ROM during gait also improved significantly post-THA.
Coronal and axial spinal and hip ROM increased post-THA during seated trunk rotation and gait, indicating normalization across planes.

Conclusions:

Spinopelvic motion demonstrates dynamic normalization across sagittal, coronal, and axial planes after THA.
These findings support the dynamic nature of spinopelvic characteristics post-surgery.
Predictive models incorporating these dynamic changes are needed for optimizing surgical planning.