Leg power, pelvic movement and physical activity after periacetabular osteotomy. A prospective cohort study.

To investigate changes in leg power, pelvic movement and patient-reported outcome in patients with hip dysplasia one year after periacetabular osteotomy. Forty-one patients (7 males) with a mean age of 28.8 years scheduled for periacetabular osteotomy were tested before surgery, and 4 and 12 months after. Leg power, pelvic range of motion and the Hip and Groin Outcome Score (HAGOS) was collected. One year after surgery, power in the operated leg had improved (p = 0.004) and there was no significant difference between power in the operated leg and contralateral leg (p = 0.22). In the frontal plane, pelvic range of motion decreased significant during stair-climbing and stepping down. The same pattern was seen in the sagittal plane but the changes were non-significant. All subscales on the HAGOS improved significantly over time (p < 0.001). Leg power and pelvic range of motion in patients with symptomatic hip dysplasia improved 12 months after periacetabular.

Use of accelerometer-based activity monitoring in orthopaedics: benefits, impact and practical considerations.

Studies of the effectiveness of orthopaedic interventions do not generally measure physical activity (PA). Applying accelerometer-based activity monitoring in orthopaedic studies will add relevant information to the generally examined physical function and pain assessment.Accelerometer-based activity monitoring is practically feasible in orthopaedic patient populations, since current day activity sensors have battery time and memory to measure continuously for several weeks without requiring technical expertise.The ongoing development in sensor technology has made it possible to combine functional tests with activity monitoring.For clinicians, the application of accelerometer-based activity monitoring can provide a measure of PA and can be used for clinical comparisons before and after interventions.In orthopaedic rehabilitation, accelerometer-based activity monitoring may be used to help patients reach their targets for PA and to coach patients towards a more active lifestyle through direct feedback. Cite this article: EFORT Open Rev 2019;4:678-685. DOI: 10.1302/2058-5241.4.180041.

Reliability of the Danish version of the short questionnaire to assess health-enhancing physical activity (SQUASH).

OBJECTIVE: To translate and cross-cultural adapt the short questionnaire to assess health-enhancing physical activity (SQUASH) to Danish, and to investigate the Danish version's reliability. METHODS: The study was conducted according to the COSMIN guidelines. The reliability was evaluated in 53 healthy subjects, mean age 47.1 ± 12.4 years and mean period 37.8 ± 14.8 days between test and retest. RESULTS: For the total activity score ICC was 0.73 (0.57 to 0.83), SEM was 2316 (24% of the grand mean), and SDC was 6419 (67% of the grand mean). CONCLUSION: The relative reliability was acceptable and indicates that the Danish version of SQUASH can be used to distinguish between individuals; however, the absolute reliability was poor and SQUASH is not considered suitable for measuring physical activity on an individual level.

Are patients with knee osteoarthritis and patients with knee joint replacement as physically active as healthy persons?

BACKGROUND: It is well documented that patients with knee osteoarthritis (KOA) suffer from reduced physical function and that function of the affected knee is improved after knee joint replacement (KJR). However, it remains uncertain whether patients with KOA are less physically active than healthy people and whether patients increase their level of physical activity after surgery to a level comparable with that of healthy people. The aim of this study was to examine whether patients with KOA are less physically active than healthy participants and whether patients who have undergone KJR show an increased activity and achieve the same level of physical activity as healthy participants 5 years postoperatively. METHODS: Fifty-four patients with KOA (29 women; mean age 62 ± 8.6; mean body mass index (BMI) 27 ± 5), 52 patients who had KJR due to KOA 5 years earlier (26 women; mean age 66 ± 7.2; mean BMI 30 ± 5) and 171 healthy participants (76 women, mean age 64 ± 9.7, mean BMI 26 ± 5) were included in this cross-sectional study. The level of physical activity was measured over a mean period of 5.5 days with a triaxial accelerometer mounted on the thigh. Number of daily steps, number of daily short walking bouts of <10 s duration and number of daily transfers from sitting to standing position were recorded. Data were analysed using two sample t tests and were adjusted for age, gender and BMI. RESULTS: Patients with KOA did not differ significantly from healthy participants regarding daily steps (+321, p = 0.50) or daily transfers from sitting to standing (+1.9, p = 0.52) but performed significantly less daily short walking bouts <10 s (-11.9, p = 0.02). Patients after KJR did not differ significantly from healthy participants regarding daily steps (-281, p = 0.60) of transfers from sitting to standing position (-3.2, p = 0.32) but performed significantly less daily short walking bouts <10 s (-21.7, p = 0.001). CONCLUSION: Patients with KOA and KJR showed no significant reduction in number of daily step counts and transfers from sitting to standing position when compared with matched healthy controls. However, the number of short walking bouts was reduced in patients with KOA and by twice as much in patients with KJR. This indicates that KOA and treatment with KJR hardly affect health-related general activity but do affect specific physical activity behaviour potentially indicative of KOA or post-KJR functional limitations. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE: Activity monitoring with an accelerometer-based method gives insights into health-related general activity levels such as total daily steps and specific parameters such as short walking bouts, which may serve as an objective outcome measure in clinical practice.

Posterior or anterolateral approach in hip joint arthroplasty - Impact on frontal plane moment.

BACKGROUND: Anterolateral surgical approach in hip joint arthroplasty necessitates division of the hip abductor muscle complex, which may compromise postoperative gait observed in the frontal plane. The aim of the study was to compare frontal plane moment after hip joint arthroplasty by anterolateral or posterior approach and to explore which compensatory strategies patients use to decrease frontal plane moment. METHODS: Twenty-eight patients were randomized by sealed envelopes to hip resurfacing arthroplasty surgery by anterolateral (ad modum Watson) or posterior (ad modum Moore) approach, performed by two senior surgeons. Gait analyses were performed using 3D motion capture before surgery, 3, and 12 months after surgery. Peak ground reaction force was extracted for early and late stance and the corresponding frontal plane moment was defined. Measures of lateral trunk inclination, pelvic drop and hip abduction were obtained for the stance phase of the affected leg. FINDINGS: An effect of surgical approach on frontal plane moment for the affected leg was found during early stance phase (p = 0.006) where average frontal plane moment in the anterolateral groups was 202.42 N mm/kg in less compared to the posterior group after one year. A similar effect from baseline to 12 months for trunk inclination (p = 0.03) and an overall negative correlation between frontal plane moment and trunk inclination was found (r = -0.66, p = 0.03). INTERPRETATION: Frontal plane moment during early stance was less one year after hip joint arthroplasty through anterolateral compared to posterior approach. Patients' primary strategy to reduce frontal plane moment seems to be increased lateral trunk inclination.