title: Gait and gait-related activities of daily living after total hip arthroplasty: a systematic review.
abstract: BACKGROUND
  Differences in the performance of gait and gait-related activities of daily living are known to persist after total hip arthroplasty compared to healthy controls, but the specific underlying deficits (spatiotemporal, kinematics and kinetics) are not completely understood. This review aimed to map the differences between patients and controls, and between the operated and non-operated limbs during various activities of daily living.
  
  
  METHODS
  A computerized search with broad search terms was performed in the MEDLINE database. Primary inclusion criteria were: primary osteoarthritis as indication, comparison with healthy controls or comparison between the operated and the non-operated limbs, and follow-up period at least six months after surgery.
  
  
  RESULTS
  The literature search yielded 2177 citations, of which 35 articles were included. Compared to controls, reductions were identified in the operated hip in sagittal range of motion, peak extension, sagittal power generation, abduction moment and external rotation moment. During stair ascent, these reductions did not become more apparent, although deficits in hip kinetics in all three planes were found. Walking speed and step length were reduced compared to controls at longer-term follow-up, but not at short-term follow-up.
  
  
  CONCLUSIONS
  The hip abduction moment deficit was present both in level walking and in stair ascent in total hip arthroplasty patients compared to controls. Reduced sagittal hip power generation and external rotation moment were also found, of which the clinical relevance remains to be established. Due to a low number of studies, many of the longer-term effects of THA on gait and gait-related ADL are not yet accurately known.
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Rehabilitation, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: sjoerd.kolk@radboudumc.nl.
authors.forename: Sjoerd
authors.initials: S
authors.lastname: Kolk
authors.affiliation: Sint Maartenskliniek Research, Hengstdal 3, 6522 JV Nijmegen, The Netherlands.
authors.forename: Michiel J M
authors.initials: MJ
authors.lastname: Minten
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Rehabilitation, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: Geert E A
authors.initials: GE
authors.lastname: van Bon
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Orthopaedics, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: Wim H
authors.initials: WH
authors.lastname: Rijnen
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Rehabilitation, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: Alexander C H
authors.initials: AC
authors.lastname: Geurts
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Orthopaedic Research Laboratory, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; Laboratory for Biomechanical Engineering, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
authors.forename: Nico
authors.initials: N
authors.lastname: Verdonschot
authors.affiliation: Sint Maartenskliniek Research, Hengstdal 3, 6522 JV Nijmegen, The Netherlands.
authors.forename: Vivian
authors.initials: V
authors.lastname: Weerdesteyn
mesh_terms: D000203:Activities of Daily Living; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation; D001696:Biomechanical Phenomena / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D016138:Walking
keywords: Activities of daily living; Osteoarthritis; Stair climbing; Temporospatial parameters; Total hip replacement; Walking