A prospective randomized assessment of earlier functional recovery in THA patients treated by minimally invasive direct anterior approach: a gait analysis study.

Authors:
Eckart Mayr
Eckart Mayr
Medical University Innsbruck
Austria
Michael Nogler
Michael Nogler
Medical University Innsbruck
Innsbruck | Austria
Oliver Kessler
Oliver Kessler
University of Zurich
Switzerland
Andrea Reinthaler
Andrea Reinthaler
Medical University Innsbruck
Austria
Martin Krismer
Martin Krismer
Innsbruck Medical University
Alberto Leardini
Alberto Leardini
Università degli Studi di Bologna
Italy

Clin Biomech (Bristol, Avon) 2009 Dec 21;24(10):812-8. Epub 2009 Aug 21.

Department for Orthopaedic Surgery/Experimental Orthopaedics, Medical University Innsbruck, Salurnerstr. 15, A-6020 Innsbruck, Austria.

Background: Total hip replacement using a minimally invasive surgical approach is claimed to enable recovering of motor function more quickly. The purpose of this prospective As per the stylesheet, kindly provide section headings for abstract.and randomized study was to test this claim by evaluating early patient functional outcomes by gait analysis.

Methods: Seventeen patients were operated on using a traditional anterolateral approach (AL), 16 using a minimally invasive direct anterior approach (DA). Gait analysis was performed the day before surgery, and at 6 and 12 weeks after surgery. Time-distance and kinematics analyses were performed by a recently proposed anatomically-based gait analysis protocol. A static double-leg stance and five walking trials at self-selected speeds were recorded on a 9-m walkway.

Findings: At 6 weeks follow-up, but in the DA group only, a statistically significant improvement with respect to preoperative status was observed for the percentage of single support and for the stride time. Between 6- and 12-week follow-up, the DA group showed a significant improvement in cadence, stride time and length, walking speed, hip flexion at foot contact, maximum hip flexion in swing, and hip total range of motion in the sagittal and the coronal planes. Between 6 and 12 weeks, the AL group showed significant improvements in opposite foot contact and step time, and in flexion at foot contact, maximum flexion in swing, and range of flexion at the hip joint.

Interpretation: Minimally invasive DA patients improved in a larger number of gait parameters than patients receiving the traditional AL approach. The majority of improvements occurred between the 6- and 12-week follow-ups.

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http://dx.doi.org/10.1016/j.clinbiomech.2009.07.010DOI Listing
December 2009
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