Acetabular pressures during hip arthritis exercises

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Abstract
Objective. To examine in vivo maximum acetabular contact pressures during gait and hip arthritis exercises recommended by clinicians and the Arthritis Foundation. Methods. Acetabular contact pressure data were collected for 2.5 years, at 3‐4‐month intervals, from an instrumented endoprosthesis implanted in an 84‐year‐old male who had sustained a left hip fracture. Maximum pressure data were compared for each activity. Results. Mean pressures ranged from 9.0 ± 2.3 megapascals (MPa) during maximum isometric hip abduction, 9.0 ± 0.8 MPa during standing right hip abduction, and 8.9 ± 2.8 MPa during standing left hip abduction to 1.2 ± 0.3 MPa during quiet standing. Freespeed gait pressure averaged 5.6 ± 0.9 MPa. The maximum mean pressure during side‐lying hip abduction and straight leg raise at 30° second were less than the same activities at 60° second. Conclusions. These in vivo hip pressure measurements challenge traditional protocols for patients with hip osteoarthritis and provide quantitative data as a framework for designing exercise programs. Maximum isometric hip exercise and standing exercise generated much higher hip pressures, and are therefore probably more stressful to acetabular cartilage, than gait or stationary cycling. Clinicians must consider exercise velocity because of its direct correlation with hip contact pressure. Walking generated lower pressure than most activities studied and, given its other benefits, is therefore probably beneficial for patients with hip osteoarthritis.