Total hip arthroplasty surgical approach does not alter postoperative gait mechanics one year after surgery
Abstract
Objective: To investigate the differences in gait biomechanics on the basis of surgical
approach 1 year after surgery. Design: 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 1year 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. Setting: A controlled laboratory study. Participants: 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. Main Outcome Measurements: 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. Conclusion: 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. © 2014 American Academy of Physical Medicine and
Rehabilitation.
Type
Journal articlePermalink
https://hdl.handle.net/10161/8906Published Version (Please cite this version)
10.1016/j.pmrj.2013.09.006Publication Info
Queen, Robin M; Appleton, J Stephen; Butler, Robert J; Newman, Erik T; Kelley, Scott
S; Attarian, David E; & Bolognesi, Michael P (2014). Total hip arthroplasty surgical approach does not alter postoperative gait mechanics
one year after surgery. PM and R, 6(3). pp. 221-226. 10.1016/j.pmrj.2013.09.006. Retrieved from https://hdl.handle.net/10161/8906.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
David Edward Attarian
Professor of Orthopaedic Surgery
Investigation of value based healthcare markets and transitions. Cost transparency
for patients and providers.Risk management and medicolegal aspects of orthopaedic
practice. Co-management and alignment relationships between clinicians and hospitals/
health systems in evolving healthcare markets. Clinical outcomes of total hip and
knee replacements (primary and revision surgeries, total joint infections, modern
bearing surfaces, gait mechanics and balance). Novel surgical
Michael Paul Bolognesi
Professor of Orthopaedic Surgery
As chief of the adult reconstruction service, the majority of my research effort has
been directed toward clinical outcomes, implant survivorship, functional recovery,
the biology of hip and knee arthritis and cost effectiveness.
Robert John Butler
Adjunct Associate Professor in the Department of Orthopaedic Surgery
Construction of standards for a functional testing continuum for ACL patients to optimize
durability and performance.Development of field expedient tests to predict musculoskeletal
injury. Predictors of the early presentation of knee osteoarthritis following a joint
injury.
Scott Streater Kelley
Professor of Orthopaedic Surgery
Robin Marie Queen
Assistant Professor of Orthopaedic Surgery
This author no longer has a Scholars@Duke profile, so the information shown here reflects
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