Leg length and offset differences above 5 mm after total hip arthroplasty are associated with altered gait kinematics

  • 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 5 mm) or non-restored (more than 5 mm reduction or more than 5 mm 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 5 mm 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 5 mm relate to unphysiological gait kinematics within the first year after THA. DRKS00000739, German Clinical Trials Register.

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Metadaten
Author:Tobias Renkawitz, Tim A. Weber, Silvia Dullien, Michael Woerner, Sebastian DendorferORCiD, Joachim Grifka, Markus Weber
DOI:https://doi.org/10.1016/j.gaitpost.2016.07.011
Parent Title (English):Gait & Posture
Document Type:Article
Language:English
Year of first Publication:2016
Release Date:2020/03/03
Tag:Biomechanics; Gait analysis; Leg length; Offset; THA
Volume:vol. 49
First Page:196
Last Page:201
Institutes:Fakult├Ąt Maschinenbau
Regensburg Center of Biomedical Engineering - RCBE
Labor Biomechanik - LBM