COMPARISION OF GAIT PARAMETERS IN PATIENTS WITH TOTAL HIP ARTHROPLASTY FOLLOWING DIRECT LATERAL AND ANTEROLATERAL SURGICAL APPROACH

摘要

In 20 patients with unilateral osteoarthris, who underwent total hip arthroplasty (THA) using a direct-lateral approach and in 19 patients with unilateral hip osteoarthritis, who underwent THA using an antero-lateral approach, the gait was analyzed using a zebris ultrasound-based three-dimensional motion analysis system. The constant gait speed was 2.5 km/h. The spatial-temporal angular and kinetics parameters determined preoperatively and 3, 6, and 12 months after THA are compared to each other and to the gait parameters of 20 healthy, elderly subjects. The aim of this study is to determine how selected gait parameters change as a result of total hip arthoplasty at constant gait speed, to examine the effects of the surgical procedure on the biomechanics of gait twelve months postoperatively and to perform comparisons between gait parameters determined 3, 6, 12 months after THA and those of healthy persons, before THA asymmetry was observed in spatial-temporal parameters, in hip motion, in knee motion, as well as in kinetical parameters. The study showed that increased pelvic obliquity and flexion-extension worked as compensation. It seems that the range of pelvic rotation was not involved, even in our patients with unilateral osteoarthritis of the hip joint. Almost all of the patients who underwent THA using a DL approach have limitation of hip motion, increasing of pelvic rotation, and asymmetry of loading. In contrast, most of AL patients exhibited gait patterns that most resembled the control group, indicating a better outcome when using the AL approach. These findings are based on gait parameters at twelve months postoperatively. The greatest improvements have been shown to occur during the first year after operation, but improvement in gait ability continues over one or two years postoperatively. Therefore, with monitored rehabilitation, with strengthening hip extensors and with stretching hip joints could improve the provision of a more normal gait.