title: Functional recovery of muscles after minimally invasive total hip arthroplasty.
abstract: Whether mini-incision total hip arthroplasty is associated with accelerated postoperative recovery is a subject of considerable controversy. A study was conducted to compare objective outcomes using gait analysis as a measure for recovery of function in patients treated with three different minimally invasive surgical approaches and the traditional posterior approach. Sixty-nine patients underwent instrumented gait analysis at self-selected and fast velocities preoperatively and at 6 weeks and 3 months postoperatively. Four surgical groups were studied-30 treated with posterior mini-incisions, 11 anterolateral, 10 anterior Judet, and 18 traditional posterior long incisions. Overall, gait velocity increased slightly at 6 weeks and significantly at 3 months. However, there were no significant differences between groups for velocity, cadence, stride length, single-limb support time, or double-limb support time at 6 weeks or 3 months postoperatively. These data indicate that patients undergoing total hip arthroplasty with any of these surgical approaches recover muscle function, as measured by gait analysis, to preoperative levels within 6 weeks postoperatively. No advantage was shown with the use of any of the three different small-incision approaches. This finding suggests that the amount of muscle, or the particular muscle cut, does not have a significant effect on the recovery of postoperative gait function.
authors.affiliation: Department of Radiology, University of California San Diego, San Diego, California, USA.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Ward
authors.forename: Richard E
authors.initials: RE
authors.lastname: Jones
authors.forename: William T
authors.initials: WT
authors.lastname: Long
authors.forename: Debra J
authors.initials: DJ
authors.lastname: Thomas
authors.forename: Lawrence D
authors.initials: LD
authors.lastname: Dorr
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D015992:Body Mass Index; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D018482:Muscle, Skeletal / Q000502:physiology* / Q000601:surgery; D011184:Postoperative Period; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome