Markers of gait disorders in patients after hip joint prosthesis as a result of a long-term osteoarthrosis (according to the GAITRite system)

Background. The long course of the degenerative process leads to some anatomical transformations in the muscles and joints of the entire skeleton: the appearance of flexion-causing contractures, shortening of the limb, pelvic distortion and the development of degenerative scoliosis. The patient’s adaptability to a new image forms his new habit of movement. The hip arthroplasty relieves pain, eliminates other complications of degenerative processes, but a new habit of movement remains, although to a lesser extent. The clinical result, confirmed by X-ray diffraction, may be excellent, but a patient has a slight lameness, a noticeable difference in the length of steps and in transferring the foot when walking. Early diagnosis of these residual pathological habits and adequate physical rehabilitation will allow patients to restore the full volume of the joints. Hardware examinations minimize the doctor’s error, make it possible to obtain digital material and determine the patient’s functional ability. The purpose of the work is to determine the main markers of gait disorders after hip replacement in patients with a long course of degenerative diseases according to the GAITRite system. Materials and methods. We examined 36 patients aged 20 to 73 years with a disease duration of at least 7 years. Young patients (up to 35 years — 3 patients) had a history of congenital malformations of the hip joint with surgery. In all patients, developed flexion-causing contractures of the hip joint from 5° to 15° were observed. Patients were examined before and 6 months after the hip arthroplasty. The research was conducted on a GAITRite device (The GAITRite Electronic Walkway, USA). The temporal and geometrical parameters of patients’ walking were determined. Results. An analysis of the data showed that 6 months after hip replacement, patients showed a significant improvement in walking parameters. The duration of the steps and their length are levelled, but almost all patients have a violation of the support on the foot of the prosthetic limb and the foot is not restored to normal, a patient has a reduced phase of the transfer of the foot of the prosthetic limb (Single Support, %) compared to a healthy one, while phase of reliance on a healthy (Stance, %) limb is not equal to the phase of foot transferring. Patients lose the smoothness of walking, they carefully step on the foot of the prosthetic limb, keeping it from full support for a split second. Patients have acquired the habit of reducing the phase of support on the full foot. The analysis results make it clear that the periods of touching the heel and fingers increase, and the period of the roll decreases. U-turn of the foot is not completely restored after arthroplasty. Conclusions. Careful research suggests that the asymmetry of steps persists. The acquired habit of improper installation of the foot, caution when transferring body weight to the foot of a sore foot, the picture of foot transfer in most cases persists after hip arthroplasty, although to a much lesser extent. That is, that was acquired by a patient as an adaptive mechanism during pathological walking, remains after the elimination of problems with the joints. Slight asymmetries of the steps lead to a violation of the anatomical relationships in the work of the muscles, a change in their levers, which again causes a vicious circle of slow accumulation of pathological changes in the anatomical structures of the body.