title: Impact of the method of exposure in total hip arthroplasty on the variability of gait in the first 6months of the postoperative period.
abstract: Gait analysis has provided important information about the variability of gait for patients prior to and after total hip arthroplasty (THA). The objective of this research was to clarify how the method of exposure in total hip arthroplasty affects the variability of gait.
  
  
  METHODS
  Gait analysis was performed at 0.8m/s, 1.0m/s, and 1.2m/s on 25 patients with direct-lateral exposure (DL), 22 with antero-lateral exposure (AL) and 25 with posterior exposure (P) during total hip arthroplasty. The control group was represented by 45 healthy subjects of identical age. Gait analysis was performed pre-operatively and 3 and 6months after the surgery. Gait parameter variability was characterized by the coefficient of variance (CV) of spatial-temporal parameters and by the mean coefficient of variance (MeanCV) of angular parameters.
  
  
  RESULTS
  The variability of gait tends to reach control values during the first 6months of the postoperative period in all three patient groups. Six months after THA, in patients operated with DL and AL exposure the variability of gait differs significantly from control values; however, in patients operated with P exposure, the variability of spatial-temporal and angular parameters - except the rotation of pelvis - was similar to that of controls.
  
  
  CONCLUSIONS
  The type of surgical technique significantly influences the variability of gait. Difference in the variability of angular parameters predicts gait instability and increased risk of falling after THA without the joint capsule preserved. Joint capsule preservation ensures a recovery of gait variability. It should be taken into account when compiling rehabilitation protocols. Differences related to the method of exposure should be considered when abandoning therapeutic aids.
authors: Semmelweis University, Department of Orthopaedics, Hungary.
authors: Gergely
authors: G
authors: Holnapy
authors: Arpád
authors: A
authors: Illyés
authors: Rita M
authors: RM
authors: Kiss
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005684:Gait; D006621:Hip Joint / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D016059:Range of Motion, Articular; D020127:Recovery of Function / Q000502:physiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016138:Walking