title: Rehabilitation of gait in patients after total hip arthroplasty: Comparison of the minimal invasive Yale 2-incision technique and the conventional lateral approach.
abstract: The minimal invasive anterolateral Yale 2-incision approach for total hip arthroplasty aims minimizing damage to the muscles for faster recovery of function. Therefore the hypothesis was investigated, that during the rehabilitation process the Yale approach shows a faster return to natural gait than a conventional lateral approach. Nineteen patients had the Yale, 16 the conventional Bauer approach. Instrumented gait analysis was performed 3 days, 3 and 12 month post operatively. Velocity, cadence, step length, weight bearing, thorax lean, Trendelenburg limp, hip abduction moments, and hip muscle activation times were evaluated. Three days post-surgery a significantly greater loading of the treated limb and increased hip abduction moment were observed in the Yale group. In addition, the Yale group showed its greatest improvement in walking speed and step length between at 3 days and 3 months, whereas the conventional group showed an additional significant gain between 3 and 12 month to reach a similar walking speed as the Yale group. For all hip muscles investigated, only muscle tensor fasciae latae in the conventional group showed a significant increase in activation time between 3 days and 3 months. This study showed significantly faster return to natural gait in the Yale compared to the conventional approach, which could be biomechanically related to less impairment of abductor muscles in the Yale approach.
authors.affiliation: Orthopaedic Hospital for Children, Behandlungszentrum Aschau, Germany. Electronic address: h.boehm@bz-aschau.de.
authors.forename: Harald
authors.initials: H
authors.lastname: Böhm
authors.affiliation: Wolfart Clinic Gräfelfing, Department Orthopaedics and Endoprothetics, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hagemeyer
authors.affiliation: Social-pediatric center in Munich, Germany.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Thummerer
authors.affiliation: Wolfart Clinic Gräfelfing, Department Orthopaedics and Endoprothetics, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Kipping
authors.affiliation: Siegfried Weller Institute for Trauma Research, BG Trauma Center Tübingen, Eberhard Karls University of Tübingen, Germany. Electronic address: ustoeckle@bgu-tuebingen.de.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stöckle
authors.affiliation: Wolfart Clinic Gräfelfing, Department Orthopaedics and Endoprothetics, Germany.
authors.forename: Konrad
authors.initials: K
authors.lastname: Scheuerer
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods* / Q000534:rehabilitation*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D020127:Recovery of Function / Q000502:physiology
keywords: 2 incision approach; Gait; Hip arthroplasty; MIS hip surgery; Rehabilitation; Yale-technique