Gait analysis after total hip arthroplasty with leg-length equalization in women with unilateral congenital complete dislocation of the hip--comparison with untreated patients.
Patients with Crowe Type-IV congenital dislocation of the hip (CDH) show significant clinical improvement after total hip arthroplasty (THA) because this surgery greatly reduces pain. Concomitant leg-length equalization in unilateral patients--a controversial procedure--theoretically should significantly improve these patients' ability to walk efficiently and comfortably. To understand the impact of leg-length equalization on these patients, we compared their gait parameters with those of untreated patients without pain but with leg-length discrepancy. Using a motion analysis system, three force platforms and computer calculation, the gait parameters during level walking of 22 women with unilateral Crowe Type-IV CDH were studied at an average of 58 months (27-98 months) following a successful cementless THA. The socket was placed in the best bone stock, which was close to the level of the true acetabulum. The leg-length discrepancy was equalized to within 2 cm in all patients. The Harris hip score averaged 94.8 (range, 88-100) at the time of the study. Nine women with untreated unilateral Crowe Type-IV CDH without major pain but with an average leg-length discrepancy of 4.7 cm (range, 2.5-6 cm) were also studied for comparison. The treated subjects (Group 1; THA and leg-length equalization) walked faster and had gait parameters with better bilateral symmetry than the untreated subjects (Group 2). We concluded that leg-length equalization in addition to THA in patients with unilateral Crowe Type-IV CDH significantly improves gait symmetry and efficiency.
Lai
K A
KA
Department of Orthopedics, National Cheng Kung University, Tainan, Taiwan. ntchiu@mail.ncku.edu.tw
Lin
C J
CJ
Jou
I M
IM
Su
F C
FC
D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005684:Gait; D006618:Hip Dislocation, Congenital / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007870:Leg Length Inequality / Q000601:surgery*