title: No strength or gait benefit of two-incision THA: a brief followup at 1 year.
abstract: BACKGROUND
  Using comprehensive gait analysis and strength testing, we previously investigated the early (2-month) functional outcome after THA using two-incision and mini-posterior surgical approaches and found an advantage for the mini-posterior approach. Benefits included improved muscle strength, a less antalgic gait, and better hip function as reflected by changes in hip moments during level walking and stair climbing. We questioned how these differences in function would fare with longer followup.
  
  
  OBJECTIVE
  We determined whether the observed early functional advantages for the mini-posterior technique over the two-incision technique were still present 1 year postoperatively.
  
  
  METHODS
  We prospectively enrolled 22 patients with primary degenerative arthritis of the hip; of these, 21 completed gait and strength testing at 2 months, and 19 completed comprehensive gait and strength testing at 1 year (11 two-incision hips, eight mini-posterior hips). The 19 patients included 11 men and eight women with a mean age of 65 years (range, 40-85 years) and a mean (BMI) of 29 (range, 21-39).
  
  
  RESULTS
  At 1 year postoperatively, the patients who had the mini-posterior THA had greater improvement in hip flexion strength and internal rotation strength, greater increase in hip flexor internal moment, and greater increase in single-leg stance time on level ground over the patients who had the two-incision THA.
  
  
  CONCLUSIONS
  Compared with the two-incision approach, patients undergoing mini-posterior THA had persistently better function, including hip flexor and internal rotator muscle strength, hip flexor internal moment, and single-leg stance during level walking.
  
  
  METHODS
  Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Krych
authors.forename: Mark W
authors.initials: MW
authors.lastname: Pagnano
authors.forename: Krista
authors.initials: K
authors.lastname: Coleman Wood
authors.forename: R Michael
authors.initials: RM
authors.lastname: Meneghini
authors.forename: Kenton
authors.initials: K
authors.lastname: Kaufman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D053580:Muscle Strength; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013997:Time Factors; D019415:Torque; D016896:Treatment Outcome; D016138:Walking