title: Gait alterations can reduce the risk of edge loading.
abstract: Following metal-on-metal hip arthroplasty, edge loading (i.e., loading near the edge of a prosthesis cup) can increase wear and lead to early revision. The position and coverage angle of the prosthesis cup influence the risk of edge loading. This study investigates the effect of altered gait patterns, more specific hip, and pelvis kinematics, on the orientation of hip contact force and the consequent risk of antero-superior edge loading using muscle driven simulations of gait. With a cup orientation of 25° anteversion and 50° inclination and a coverage angle of 168°, many gait patterns presented risk of edge loading. Specifically at terminal double support, 189 out of 405 gait patterns indicated a risk of edge loading. At this time instant, the high hip contact forces and the proximity of the hip contact force to the edge of the cup indicated the likelihood of the occurrence of edge loading. Although the cup position contributed most to edge loading, altering kinematics considerably influenced the risk of edge loading. Increased hip abduction, resulting in decreasing hip contact force magnitude, and decreased hip extension, resulting in decreased risk on edge loading, are gait strategies that could prevent edge loading. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1069-1076, 2016.
authors.affiliation: Department of Kinesiology, Human Movement Biomechanics, KU Leuven, Heverlee, Belgium.
authors.forename: Mariska
authors.initials: M
authors.lastname: Wesseling
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
authors.forename: Christophe
authors.initials: C
authors.lastname: Meyer
authors.affiliation: Division PMA, Department of Mechanical Engineering, KU Leuven, Heverlee, Belgium.
authors.forename: Friedl
authors.initials: F
authors.lastname: De Groote
authors.affiliation: Department of Orthopaedic, Ziekenhuis Oost-Limburg, Hip Unit, Genk, Belgium.
authors.forename: Kristoff
authors.initials: K
authors.lastname: Corten
authors.affiliation: Department of UZ Pellenberg Orthopedic, University Hospitals Leuven, Pellenberg, Belgium.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Simon
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
authors.forename: Kaat
authors.initials: K
authors.lastname: Desloovere
authors.affiliation: Department of Kinesiology, Human Movement Biomechanics, KU Leuven, Heverlee, Belgium.
authors.forename: Ilse
authors.initials: I
authors.lastname: Jonkers
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*
keywords: edge loading; gait; hip arthroplasty; hip contact force