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

Eckart Mayr, Michael Nogler, Maria Grazia Benedetti, Oliver Kessler, Andrea Reinthaler, Martin Krismer, Alberto Leardini

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)812-818
Number of pages7
JournalClinical Biomechanics
Volume24
Issue number10
DOIs
Publication statusPublished - Dec 2009

Keywords

  • Functional recovery
  • Gait analysis
  • Hip surgery
  • Minimally invasive

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Biophysics

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