Spatiotemporal parameters of gait after total hip replacement: anterior versus posterior approach

The objective of this preliminary study was to examine possible differences in gait characteristics between subjects operated by way of a direct anterior approach and a posterior approach for primary total-hip arthroplasty, and age-matched healthy controls. Fifty-one subjects walked over an instrumented mat at two different speeds (self-selected comfortable and faster than normal) and spatiotemporal gait parameters were calculated using a validated methodology. Despite excellent clinical and radiographic scores, and irrespective of surgical approach, patients demonstrated an impaired walking performance (lower velocity and shorter step lengths) during fast walking, but not at the self-selected comfortable speed compared with healthy controls. Subjects operated with the posterior approach reported significantly higher stiffness than anterior subjects, but similar pain and function. Six months after total arthroplasty for primary osteoarthritis of the hip, gait characteristics were comparable between subjects having received the direct anterior approach and the posterior approach.