No difference in gait recovery after THA with different head diameters: a prospective randomized study

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Gait Analysis

Background:

• Larger femoral heads in total hip arthroplasty (THA) are often presumed to enhance joint stability and hip biomechanics.
• Previous research suggested larger heads might accelerate normal gait recovery post-THA.

Purpose of the Study:

• To compare spatiotemporal, kinematic, and kinetic gait parameters, alongside Harris hip scores, in THA patients receiving different femoral head sizes (28, 36, or ≥42 mm).
• To test the hypothesis that larger femoral heads lead to earlier and more physiological gait pattern restoration.

Main Methods:

• A randomized, blinded study of 60 primary hip arthritis patients (55-70 years, female) undergoing cementless THA.
• Patients were randomized into three groups based on bearing couple size: 28mm, 36mm, or ≥42mm.
• Gait analysis using an optoelectronic system was conducted preoperatively and at 2 and 4 months postoperatively, with a standardized rehabilitation protocol.

Main Results:

• No significant differences were observed in spatiotemporal gait parameters, kinematic or kinetic gait parameters, or Harris hip scores among the three femoral head size groups.
• While all patient groups showed improvements in assessed variables at 4 months postoperatively, these improvements were not statistically significant between the groups.

Conclusions:

• The study did not support the hypothesis that larger femoral heads in THA lead to superior early gait performance.
• Femoral head size did not demonstrate a significant impact on early gait recovery or functional outcomes in this patient cohort.