Article

The minimal invasive anterolateral Yale 2-incision approach for total hip
arthroplasty aims minimizing damage to the muscles for faster recovery of
function. Therefore the hypothesis was investigated, that during the
rehabilitation process the Yale approach shows a faster return to natural gait
than a conventional lateral approach. Nineteen patients had the Yale, 16 the
conventional Bauer approach. Instrumented gait analysis was performed 3 days, 3
and 12 month post operatively. Velocity, cadence, step length, weight bearing,
thorax lean, Trendelenburg limp, hip abduction moments, and hip muscle activation
times were evaluated. Three days post-surgery a significantly greater loading of
the treated limb and increased hip abduction moment were observed in the Yale
group. In addition, the Yale group showed its greatest improvement in walking
speed and step length between at 3 days and 3 months, whereas the conventional
group showed an additional significant gain between 3 and
12 month to reach a
similar walking speed as the Yale group. For all hip muscles investigated, only
muscle tensor fasciae latae in the conventional group showed a significant
increase in activation time between 3 days and 3 months. This study showed
significantly faster return to natural gait in the Yale compared to the
conventional approach, which could be biomechanically related to less impairment
of abductor muscles in the Yale approach.
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Langue : ANGLAIS