Article

We aimed to investigate the relationship between postoperative leg length/offset
(LL/OS) reconstruction and gait performance after total hip arthroplasty (THA).
In the course of a prospective randomized controlled trial, 60 patients with
unilateral hip arthrosis received cementless THA through a minimally-invasive
anterolateral surgical approach. One year post-operatively,
LL and global OS
restoration were analyzed and compared to the contralateral hip on AP pelvic
radiographs. The combined postoperative limb length/OS reconstruction of the
operated hip was categorized as restored (within 5mm) or non-restored (more than
5mm reduction or more than 5mm increment). The acetabular component inclination,
anteversion and femoral component anteversion were evaluated using CT scans of
the pelvis and the femur. 3D gait analysis of the lower extremity and patient
related outcome measures (HHS, HOOS, EQ-5D) were obtained pre-operatively, six
months and twelve months post-operatively by an observer blinded to radiographic
results. Component position of cup and stem was comparable between the restored
and non-restored group. Combined LL and OS restoration within 5mm resulted in
higher Froude number (p<0.001), normalized walking speed (p<0.001) and hip
range-of-motion (ROM) (p=0.004) during gait twelve months postoperatively,
whereas gait symmetry was comparable regardless of LL and OS reconstruction at
both examinations. Clinical scores did not show any relevant association between
the accuracy of LL or OS reconstruction and gait six/twelve months after THA. In
summary, postoperative LL/OS discrepancies larger than 5mm relate to
unphysiological gait kinematics within the first year after THA. DRKS00000739,
German Clinical Trials Register.
CI - Copyright (c) 2016 Elsevier B.V. All rights reserved.

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