Spine, Pelvis and Hip Kinematics—Characterizing the Axial Plane in Healthy and Osteoarthritic Hips

Abstract

Abnormal spinopelvic movements are associated with inferior outcomes following total hip arthroplasty (THA). This study aims to (1) characterize the agreement between dynamic motion and radiographic sagittal assessments of the spine, pelvis, and hip; (2) determine the effect of hip osteoarthritis (OA) on kinematics by comparing healthy individuals with pre-THA patients suffering from uni- or bilateral hip OA. Twenty-four OA patients pre-THA and eight healthy controls underwent lateral spinopelvic radiographs in standing and seated bend-and-reach (SBR) positions. Lumbar-lordosis (LL), sacral-slope (SS), and pelvic–femoral (PFA) angles were measured in both positions, and the differences (Δ) between SBR and standing were computed to assess spine flexion (SF), pelvic tilt (PT), and hip flexion (HF), respectively. Dynamic SBR and seated maximal trunk rotation (STR) tasks were performed at the biomechanics laboratory. Peak sagittal and axial kinematics for spine, pelvis, and hip, and range of motion (ROM), were calculated for SBR and STR. Radiograph readings correlated with sagittal kinematics during SBR for ΔLL and SFmax (r = 0.66, p r = 0.44, p = 0.014), and ΔPFA and HFmax (r = 0.70, p r = 0.33, p = 0.022) and pelvic (r =0.35, p = 0.018) flexions correlated with the axial STR rotations. All axial spinopelvic parameters were different between the OA patients and controls, with the latter exhibiting significantly greater mobility and less variability. Bilaterally affected patients exhibited lower peak and ROM compared to controls. The biomechanics laboratory performed reliable assessments of spinopelvic and hip characteristics, in which the axial plane can be included. The sagittal and axial pelvic kinematics correlate, illustrating that pelvic rotation abnormalities are likely also contributing to the inferior outcomes seen in patients with abnormal spinopelvic flexion characteristics. Axial rotations of the pelvis and spine were least in patients with bilateral hip disease, further emphasizing the importance of the hip–pelvic–spine interaction.

Keywords

• hip osteoarthritis
• kinematics
• axial plane
• motion analysis
• spinopelvic mobility