10.
Recovery in horizontal gait after hip resurfacing vs. Total hip
arthroplasty at 6-month follow-up – A RCT study
Carsten Jensen, Per Aagaard, Søren Overgaard
Orthopedic Research Unit Department of Orthopedics and Traumatology,
Odense University Hospital, Institute of Clinical Resear; , Institute of Sports
Science and Clinical Biomechanics, University of Southern Denmark;
Orthopedic Research Unit, Department of Orthopedics and Traumatology,
Odense University Hospital, Institute of Clinical Resear
Background:
Standard total hip arthroplasty (S-THA) is an established
surgical treatment for patients > 65 yrs with severe hip osteoarthritis.
However, implant survivorship curves decline more rapidly in patients < 50
yrs and resurfacing total hip arthroplasty (R-THA) has been suggested as
alternative treatment for those younger active patients. In addition, improved
walking ability and gait kinematics has been suggested after R-THA, although
never objectively examined in a RCT
Purpose / Aim of Study:
The present RCT investigated the hypothesis that (i)
gait recovery would be superior following R-THA compared to S-THA and (ii)
mechanical hip and knee muscle strength would be positively associated with
gait performance in patients with THA
Materials and Methods:
Forty-three patients were randomized and 3-
dimensional gait data were collected pre-operatively, 8 and 26 weeks post-
operatively at self-selected normal and maximal speed. Primary outcome was
gait speed while spatiotemporal and kinematics was secondary. An explorative
analysis was performed on the association between isolated hip and knee
muscle strength and gait
Findings / Results:
No treatment effect was observed for self-selected speed,
however at maximal speed S-THA patients walked faster than R-THA (+6.1%,
P=0.03). Spatiotemporal parameters and kinematics demonstrated no
difference in recovery patterns between treatments. Maximal knee and hip
muscle strength were positively associated with gait speed, step length and
cadence during maximal (r= 0.36-0.61, P<.05) but not normal walking
Conclusions:
The study could not provide evidence to support the hypothesis
that R-THA leads to superior recovery in gait and hip kinematics compared to
S-THA. Lower limb muscle strength was a predictor of gait parameters, hence
providing an important and valid functional outcome measure in individuals
undergoing THA
