Restoration of the support function of the lower limbs in children with coxarthrosis after bilateral total hip arthroplasty (Biomechanical research)

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Abstract

Background. Deforming arthrosis of the hip joint in children leads to serious disorders of the walking biomechanics due to a decrease in the support and motor functions of the lower limbs. In patients with stage III coxarthrosis, when the potential of reconstructive surgeries has been exhausted, a total hip arthroplasty is performed.

Objective. To study the biomechanical parameters of support ability of the lower limbs in children with bilateral coxarthrosis before and after bilateral total hip arthroplasty.

Material and methods. Stabilometric and plantographic studies were conducted in 12 patients with bilateral coxarthrosis, aged from 13 to 17 years old, before and after hip arthroplasty. The time interval between operations on the contralateral joints ranged from 6 to 12 months. The control group consisted of 15 children of the same age, with no signs of orthopedic disorders.

Results. Before carrying out hip arthroplasty in patients, the tension of the statokinetic system was revealed during the implementation of support for the vertical balance of the body. The plantography method made it possible to diagnose disorders of the support function of the feet in the form of supination rigidity of the anterior section, a tendency toward rigidity of the internal longitudinal arch. After bilateral total hip arthroplasty in patients, the stability of the vertical posture improved, the support ability of the heads of the 1st metatarsal bones was significantly restored, and the weight-bearing distribution across the foot sections was normalized.

Conclusion. After bilateral hip arthroplasty in patients with coxarthrosis, stabilization of the support function of the postoperative lower limbs was achieved.

About the authors

Igor E. Nikityuk

The Turner Scientific Research Institute for Children’s Orthopedics

Author for correspondence.
Email: femtotech@mail.ru
ORCID iD: 0000-0001-5546-2729

MD, PhD, Leading Researcher of the Laboratory of Physiological and Biomechanical Research

Russian Federation, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Elizaveta L. Kononova

The Turner Scientific Research Institute for Children’s Orthopedics

Email: Yelisaveta@yandex.ru
ORCID iD: 0000-0001-7624-013X

MD, PhD, Head of the Laboratory of Physiological and Biomechanical Research

Russian Federation, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Vladimir E. Baskov

The Turner Scientific Research Institute for Children’s Orthopedics

Email: dr.baskov@mail.ru

MD, PhD, Head of the Department of Hip Pathology

Russian Federation, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Khisrav D. Imomov

The Turner Scientific Research Institute for Children’s Orthopedics

Email: Kh.Imomov90@mail.ru
ORCID iD: 0000-0001-5025-7689

MD, PhD Student, Orthopedic and Trauma Surgeon of the Department of Hip Pathology

Russian Federation, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Radiograph of the hip joint (HP) of patient A, 16 years old. Spondyloepiphyseal dysplasia. Bilateral coxarthrosis, stage III: a — before hip replacement; b — after bilateral THR

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3. Fig. 2. Identification points of plantograms of healthy child B, 12 years old: a — plantogram with double support load; b —plantogram of the left foot with a single support load; c — plantogram of the right foot with a single support load

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4. Fig. 3. Plantograms of patient A, 16 years old. Spondyloepiphyseal dysplasia. Bilateral coxarthrosis, stage III (before the THR): a — with double support load; b — with a single support load of the left foot; c — with a single support load of the right foot. Deficiency of the support function of the head of the first metatarsal bone of the left foot is revealed

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5. Fig. 4. Plantograms of patient A, 16 years old. Spondyloepiphyseal dysplasia. Bilateral coxarthrosis, stage III (after total hip replacement (THR)): a — with double support load; b — with a single support load of the left foot; c — with single support load of the right foot

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Copyright (c) 2019 Nikityuk I.E., Kononova E.L., Baskov V.E., Imomov K.D.

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