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The influence of changes in the length of hip abductor moment arm after hip replacement on the features of patients’ walking (analytical review of literature)

The work deals with the main directions in the study of biomechanical features of human walking after total hip replacement in the historical aspect and present state of the problem. Special attention was paid to the problem of asymmetry in the length of the hip abductor moment arm after arthroplasty, namely the consequences to which these error leads. Methods for studying human walking biomechanics, both theoretical, in particular mathematical dynamic modeling, and device-based, are considered. Analysis of literature has shown that in severe degenerative-degenerative lesions of the hip joint, patients have severe disturbances of walking biomechanics, which is manifested in reduced time of foot support, the transfer of body weight to a healthy or relatively healthy limb, a decrease in the step length due to the significant contracture in the hip joint. In patients, there is an increase in the asymmetry of steps taken by healthy and injured limbs, according to different parameters. Often, instability of parameters from step to step is observed. Hip joint replacement leads to positive shifts of walking parameters, namely increasing the length of the step, restoring the support to the prosthetic limb. The speed of moving is increasing. But in the majority of patients, there is a lack of muscle strength, muscular system has lost the ability to function properly during the disease. In addition, the surgical intervention also affects the quality of walking. According to the literature, it was found that the asymmetry of the length of hip abductor moment arm plays negative role in slowing down the restoration of walking, especially in remote periods.