Total hip arthroplasty surgical approach does not alter postoperative gait mechanics one year after surgery.
OBJECTIVE
To investigate the differences in gait biomechanics on the basis of surgical approach 1 year after surgery.


METHODS
This was a descriptive laboratory study to investigate the side-to-side differences in walking mechanics at a self-selected walking speed as well as a functional assessment 1 year after total hip arthroplasty (THA). Temporospatial, kinetic, and kinematic data as well as functional outcomes were collected. Two-way analysis of variance was used to assess for between-group differences and limb-to-limb asymmetries.


METHODS
A controlled laboratory study.


METHODS
This study examined 35 patients with primary, unilateral THA. The THA surgical approaches that were used in these patients included 12 direct lateral, 18 posterior, and 11 anterolateral. All the patients were assessed 1 year after THA. Patients were excluded from the study if they had contralateral hip pain or pathology, or any prior lower extremity total joint replacements.


METHODS
Three-dimensional lower extremity kinematics and kinetics as well as spatiotemporal variables were collected. In addition, a series of physical performance measures were collected.


RESULTS
No main effects for the physical performance measures or biomechanical variables were observed among the approach groups. Significant limb-to-limb asymmetries were observed among all the patients, with decreased sagittal plane range of motion, peak extension, and peak vertical ground reaction forces on the operative side.


CONCLUSIONS
The results of this study indicated that no significant differences existed among the different surgical approach groups for any study variable. However, 1 year after THA, the patients demonstrated asymmetric gait patterns regardless of surgical approach, which indicated the potential need for continued intervention through physical therapy to regain normal side-to-side symmetry after THA.
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC; Michael W. Krzyzewski Human Performance Lab, 102 Finch Yeager Building, DUMC 3435, Duke University Medical Center, Durham, NC 27710(∗). Electronic address: robin.queen@duke.edu.
Robin M
RM
Queen
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC(†).
J Stephen
JS
Appleton
Michael W. Krzyzewski Human Performance Lab, Duke University Medical Center, Durham, NC; Division of Physical Therapy, Department of Community and Family Medicine, Duke University Medical Center, Durham, NC(‡).
Robert J
RJ
Butler
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC(§).
Erik T
ET
Newman
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC(‖).
Scott S
SS
Kelley
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC(¶).
David E
DE
Attarian
Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC(#).
Michael P
MP
Bolognesi
D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D001696:Biomechanical Phenomena; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013997:Time Factors; D016138:Walking / Q000502:physiology*