Review Question - QID 3644

A cane held in the contralateral hand reduces joint reactive forces through the affected hip up to 50% by reducing abductor muscle pull.

A cane create an additional force that keeps the pelvis level in the face of gravity's tendency to adduct the hip during unilateral stance. The cane's force must substitute for the hip abductors of the affected hip and creates a moment arm that is relatively long and originates on the side opposite the hip whose abductor muscles are weak. Additionally, the person needs adequate strength in the muscles of the wrist, elbow, shoulder girdle, and trunk.

Brand and Crowninshield performed a 3-dimensional hip joint reactive force evaluation of 4 different groups of patients. The groups included normal subjects, preoperative THA subjects walking without a cane, preoperative THA subjects walking with a cane, and subjects following total hip reconstruction. Each of the 3 groups evaluated without the cane had statistically similar hip joint reactive forces. The preoperative THA subjects walking with a cane and significantly lower joint reactive forces (approximately 60%).

The article by Blount was named by JBJS as a "Classics in JBJS" in 2003. It is a commentary encouraging the use of canes by describing how the biomechanics of the hip joint are altered while using a cane.

Illustration A shows some of the mathematics behind cane use.