A prospective randomized assessment of earlier functional recovery in THA patients treated by minimally invasive direct anterior approach: A gait analysis study

被引:141
作者
Mayr, Eckart [1 ]
Nogler, Michael [1 ]
Benedetti, Maria-Grazia [2 ]
Kessler, Oliver [3 ]
Reinthaler, Andrea [1 ]
Krismer, Martin [1 ]
Leardini, Alberto [2 ]
机构
[1] Med Univ Innsbruck, Dept Orthopaed Surg Expt Orthopaed, A-6020 Innsbruck, Austria
[2] Ist Ortoped Rizzoli, Movement Anal Lab, I-40136 Bologna, Italy
[3] Stryker Europe, Sci & Clin Affairs, CH-8800 Thalwil, Switzerland
关键词
Minimally invasive; Hip surgery; Functional recovery; Gait analysis; TOTAL HIP-ARTHROPLASTY; STANDARD-INCISION; AVASCULAR NECROSIS; SURGICAL APPROACH; OSTEO-ARTHRITIS; REPLACEMENT; POSTERIOR; JOINT; OSTEOARTHRITIS; STRENGTH;
D O I
10.1016/j.clinbiomech.2009.07.010
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Background: Total hip replacement using a minimally invasive surgical approach is claimed to enable recovering of motor function more quickly. The purpose of this prospective As per the stylesheet, kindly provide section headings for abstract and randomized study was to test this claim by evaluating early patient functional outcomes by gait analysis. Methods: Seventeen patients were operated on using a traditional anterolateral approach (AL), 16 using a minimally invasive direct anterior approach (DA) Gait analysis was performed the day before surgery, and at 6 and 12 weeks after surgery. Time-distance and kinematics analyses were performed by a recently proposed anatomically-based gait analysis protocol. A static double-leg stance and five walking trials at self-selected speeds were recorded on a 9-m walkway. Findings: At 6 weeks follow-up, but in the DA group only, a statistically significant improvement with respect to preoperative status was observed for the percentage of single support and for the stride time. Between 6- and 12-week follow-up, the DA group showed a significant improvement in cadence, stride time and length, walking speed, hip flexion at foot contact, maximum hip flexion in swing, and hip total range of motion in the sagittal and the coronal planes. Between 6 and 12 weeks, the AL group showed significant improvements in opposite foot contact and step time, and in flexion at foot contact, maximum flexion in swing, and range of flexion at the hip joint, Interpretation: Minimally invasive DA patients improved in a larger number of gait parameters than patients receiving the traditional AL approach. The majority of improvements occurred between the 6- and 12-week follow-ups. (C) 2009 Elsevier Ltd. All rights reserved.
引用
收藏
页码:812 / 818
页数:7
相关论文
共 43 条
[1]  
[Anonymous], CLIN ORTHOPAEDICS RE
[2]   ABDUCTOR FUNCTION AFTER TOTAL HIP-REPLACEMENT - AN ELECTROMYOGRAPHIC AND CLINICAL REVIEW [J].
BAKER, AS ;
BITOUNIS, VC .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1989, 71 (01) :47-50
[3]   TRANSGLUTEAL APPROACH TO THE HIP-JOINT [J].
BAUER, R ;
KERSCHBAUMER, F ;
POISEL, S ;
OBERTHALER, W .
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 1979, 95 (1-2) :47-49
[4]   A COMPARISON OF THE ACCURACY OF SEVERAL HIP CENTER LOCATION PREDICTION METHODS [J].
BELL, AL ;
PEDERSEN, DR ;
BRAND, RA .
JOURNAL OF BIOMECHANICS, 1990, 23 (06) :617-621
[5]  
BELLAMY N, 1988, J RHEUMATOL, V15, P1833
[6]   Data management in gait analysis for clinical applications [J].
Benedetti, MG ;
Catani, F ;
Leardini, A ;
Pignotti, E ;
Giannini, S .
CLINICAL BIOMECHANICS, 1998, 13 (03) :204-215
[7]   Comparison of immediate postoperative walking ability in patients receiving minimally invasive and standard-incision hip arthroplasty - A prospective blinded study [J].
Bennett, Damien ;
Ogonda, Luke ;
Elliott, David ;
Humphreys, Lee ;
Lawlor, Marie ;
Beverland, David .
JOURNAL OF ARTHROPLASTY, 2007, 22 (04) :490-495
[8]  
CRENSHAW A, 1992, SURG APPROACHES
[9]   Human movement analysis using stereophotogrammetry - Part 4: assessment of anatomical landmark misplacement and its effects on joint kinematics [J].
Della Croce, U ;
Leardini, A ;
Chiari, L ;
Cappozzo, A .
GAIT & POSTURE, 2005, 21 (02) :226-237
[10]   Hip abductor strength following total hip arthroplasty - A prospective comparison of the posterior and lateral approach in 100 patients [J].
Downing, ND ;
Clark, DI ;
Hutchinson, JW ;
Colclough, K ;
Howard, PW .
ACTA ORTHOPAEDICA SCANDINAVICA, 2001, 72 (03) :215-220