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Hip resurfacing generates a more physiological gait than total hip replacement: A case-control study.

Cedric Maillot1, Edouard Auvinet1, Ciara Harman2

  • 1Laboratory Block, MSK Lab, Imperial college London, White City Campus, W12 0BZ London, United Kingdom.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|April 9, 2020
PubMed
Summary

Hip resurfacing (HR) offers more consistent physiological gait than total hip replacement (THR) under stress. Anatomical restoration quality via X-ray poorly predicts THR gait performance.

Keywords:
Gait analysisHip replacementHip resurfacingKinematic alignmentSymmetry index

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Area of Science:

  • Orthopedic surgery
  • Biomechanics
  • Gait analysis

Background:

  • Restoring constitutional hip joint anatomy post-replacement is crucial for function.
  • Hip resurfacing (HR) and total hip replacement (THR) differ in anatomical reconstruction.
  • Investigating gait performance differences between HR and THR is essential.

Purpose of the Study:

  • To compare gait performance between HR and THR.
  • To determine if HR better restores frontal hip anatomical parameters and gait physiology.
  • To assess if anatomical restoration quality influences THR gait performance.

Main Methods:

  • Retrospective review of 52 patients (40 THR, 12 HR) with primary osteoarthritis.
  • Measurement of hip anatomical parameters on standing pelvic radiographs.
  • Gait assessment under normal and stress conditions at 14-month follow-up.

Main Results:

  • HR tended to decrease anatomical parameters, THR tended to increase them; significant differences in femoral and global horizontal offset.
  • Only 50% of THR and 25% of HR accurately recreated offsets.
  • HR showed more symmetric gait (2.09%) than THR (5.74%) under stress, though not statistically significant.

Conclusions:

  • HR is more consistent in achieving physiological gait under stress compared to THR.
  • Radiographic assessment of anatomical restoration quality has limited predictive value for THR gait performance.