The effect of acetabular fracture surgery on gait biomechanics; A prospective longitudinal cohort study

Acetabular fractures are severe injuries that can result in altered gait patterns. These changes may arise from the injury itself, pain related adaptations, and the impact of surgery. The aim of this study was to gain insight into frontal, sagittal and transverse plane gait deviations in patients after surgically treated acetabular fractures during rehabilitation, compared to healthy controls.

In this prospective longitudinal cohort study instrumented gait analysis was conducted at standardised speed, self-selected speed and fast speed in the patient's group at 3-, 6- and 12-months post-surgery, while matched healthy controls underwent a single assessment. Spatiotemporal parameters and frontal, sagittal and transverse plane hip, pelvis and thorax kinetics and kinematics were analysed. Statistical analysis was conducted using Statistical Parametric Mapping.

Fourteen patients surgically treated for an acetabular fracture and fourteen controls were included. At 3 months post-surgery, patients exhibited reduced self-selected gait speed, cadence, and stride length compared to 6- and 12 months of follow-up and compared to the healthy controls. Additionally, hip range of motion and moment were decreased at 3 months but returned to normal levels by 6 months. These findings suggest that the compensatory strategy for offloading the hip joint may involve temporarily reducing spatiotemporal parameters, range of motion, and moment, thereby minimizing the required hip abduction muscle force.