Activities of daily living after total hip arthroplasty. Is a 32-mm femoral head superior to a 26-mm head for improving daily activities?

Range of motion (ROM) of the hip joint after total hip arthroplasty (THA) could be increased by using a larger prosthetic femoral head, but it is not known whether the activities of daily living (ADL) are influenced by THA with different head sizes. Our objective was to compare postoperative ADL in patients who underwent THA using a head diameter of 26 mm or 32 mm. We assessed the range of motion and the mode of ADL after cementless primary THA. Comparison was performed between 25 joints of 24 patients who underwent THA with a 26-mm femoral head (26-mm group) and 24 joints of 20 patients with a 32-mm head (32-mm group). The postoperative range of flexion and abduction was significantly larger in the 32-mm group than in the 26-mm group. With respect to the mode of performing selected ADL such as putting on and removing pants, socks, and cutting toenails, many patients adopted the compensatory position of lumbar flexion with hip flexion plus knee extension in the 26-mm group, while a majority of the patients from the 32-mm group employed the mode of hip flexion with knee flexion. Patients with the 32-mm head showed better postoperative ADL of the ipsilateral side compared with the 26-mm head.