Article

OBJECTIVE: To investigate the differences in gait biomechanics on the basis of
surgical approach 1 year after surgery. DESIGN: This was a descriptive laboratory
study to investigate the side-to-side differences in walking mechanics at a
self-selected walking speed as well as a functional assessment 1 year after total
hip arthroplasty (THA). Temporospatial, kinetic, and kinematic data as well as
functional outcomes were collected. Two-way analysis of variance was used to
assess for between-group differences and limb-to-limb asymmetries. SETTING: A
controlled laboratory study. PARTICIPANTS: This study examined 35 patients with
primary, unilateral THA. The THA surgical approaches that were used in these
patients included 12 direct lateral, 18 posterior, and 11 anterolateral. All the
patients were assessed 1 year after THA. Patients were excluded from the study if
they had contralateral hip pain or pathology, or any prior lower extremity total
joint replacements. MAIN OUTCOME MEASUREMENTS: Three-dimensional lower extremity
kinematics and kinetics as well as spatiotemporal variables were collected. In
addition, a series of physical performance measures were collected. RESULTS: No
main effects for the physical performance measures or biomechanical variables
were observed among the approach groups. Significant limb-to-limb asymmetries
were observed among all the patients, with decreased sagittal plane range of
motion, peak extension, and peak vertical ground reaction forces on the operative
side. CONCLUSION: The results of this study indicated that no significant
differences existed among the different surgical approach groups for any study
variable. However, 1 year after THA, the patients demonstrated asymmetric gait
patterns regardless of surgical approach, which indicated the potential need for
continued intervention through physical therapy to regain normal side-to-side
symmetry after THA.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS