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The Effect of Surgical Approach and Hip Offset Reconstruction on Gait Biomechanics Following Total Hip Arthroplasty
Nicholas S Ryan1, Erik Kowalski1, Paul E Beaulé2
1Human Movement Biomechanics Laboratory, University of Ottawa, Ottawa, Ontario, Canada.
Background:
This study aimed to examine how hip offset (HO) and surgical approach affect gait biomechanics following total hip arthroplasty (THA).
Methods:
There were 55 THA patients assigned to 3 groups based on surgical approach (ANT: anterior, LAT: lateral, or POS: posterior) and HO difference (large HO: >5 millimeters (mm), small HO; <5 mm, or normal; between +3 mm and -3 mm). Kinematics and kinetics were recorded using motion capture and force plate data. Group differences were assessed using statistical parametric mapping.
Results:
The ANT group demonstrated more normal sagittal plane kinematics and kinetics. No frontal plane kinematic differences were found, but the LAT group displayed more normal frontal plane kinetics. The LAT group displayed a slower walking speed than the ANT group, and the LAT and POS groups used a shorter stride/step length than the control group. The large HO group showed fewer differences in sagittal plane kinematics and kinetics than the small HO and normal groups. No frontal plane kinematic differences were observed, but the normal group demonstrated more significant differences than the large HO and small HO groups. No significant differences were found between any of the HO patient groups.
Conclusion:
Anterior and lateral approaches led to more normal gait biomechanics in sagittal kinematics and frontal kinetics, respectively, but only the ANT group exhibited spatiotemporal gait parameters within normal ranges. Hip offset differences greater or less than 5 mm do not significantly change gait patterns. Surgical approach plays a greater role than HO reconstruction in producing more normal gait biomechanics following THA.
