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Total hip arthroplasty surgical approach does not alter postoperative gait mechanics one year after surgery
Robin M Queen1, J Stephen Appleton2, Robert J Butler3
1Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; Michael W. Krzyzewski Human Performance Lab, 102 Finch Yeager Building, DUMC 3435, Duke University Medical Center, Durham, NC 27710(∗).
Objective:
To investigate the differences in gait biomechanics on the basis of surgical approach 1 year after surgery.
Design:
This was a descriptive laboratory study to investigate the side-to-side differences in walking mechanics at a self-selected walking speed as well as a functional assessment 1 year after total hip arthroplasty (THA). Temporospatial, kinetic, and kinematic data as well as functional outcomes were collected. Two-way analysis of variance was used to assess for between-group differences and limb-to-limb asymmetries.
Setting:
A controlled laboratory study.
Participants:
This study examined 35 patients with primary, unilateral THA. The THA surgical approaches that were used in these patients included 12 direct lateral, 18 posterior, and 11 anterolateral. All the patients were assessed 1 year after THA. Patients were excluded from the study if they had contralateral hip pain or pathology, or any prior lower extremity total joint replacements.
Main Outcome Measurements:
Three-dimensional lower extremity kinematics and kinetics as well as spatiotemporal variables were collected. In addition, a series of physical performance measures were collected.
Results:
No main effects for the physical performance measures or biomechanical variables were observed among the approach groups. Significant limb-to-limb asymmetries were observed among all the patients, with decreased sagittal plane range of motion, peak extension, and peak vertical ground reaction forces on the operative side.
Conclusion:
The results of this study indicated that no significant differences existed among the different surgical approach groups for any study variable. However, 1 year after THA, the patients demonstrated asymmetric gait patterns regardless of surgical approach, which indicated the potential need for continued intervention through physical therapy to regain normal side-to-side symmetry after THA.
