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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
Verfasserangaben:Tobias Renkawitz, Tim A. Weber, Silvia Dullien, Michael Woerner, Sebastian DendorferORCiD, Joachim GrifkaORCiD, Markus Weber
DOI:https://doi.org/10.1016/j.gaitpost.2016.07.011
Titel des übergeordneten Werkes (Englisch):Gait & Posture
Dokumentart:Artikel aus einer Zeitschrift/Zeitung
Sprache der Veröffentlichung:Englisch
Jahr der Veröffentlichung:2016
Datum der Freischaltung:03.03.2020
Freies Schlagwort / Tag:Biomechanics; Gait analysis; Leg length; Offset; THA
Jahrgang:vol. 49
Erste Seite:196
Letzte Seite:201
Fakultäten / Institute / Einrichtungen:Fakultät Maschinenbau
Regensburg Center of Biomedical Engineering - RCBE
Fakultät Maschinenbau / Labor Biomechanik (LBM)
Begutachtungsstatus:peer-reviewed
Forschungsschwerpunkt:Lebenswissenschaften und Ethik