The Journal of Bone and Joint Surgery (American). 2010;92:328-337.
doi:10.2106/JBJS.H.01086
© 2010 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the activities for this article:
 Adult Hip Reconstruction Test 34: Spr...
CME 1: January, February, March 2010 ...
Right arrow [Supporting data]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Right arrow Sign up for keyword alerts
Google Scholar
Right arrow Articles by Pospischill, M.
Right arrow Articles by Knahr, K.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pospischill, M.
Right arrow Articles by Knahr, K.
Related Collections
Right arrow Adult Hip
Right arrow Level II
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?

Minimally Invasive Compared with Traditional Transgluteal Approach for Total Hip Arthroplasty

A Comparative Gait Analysis

M. Pospischill, MD1, A. Kranzl, Mag1, B. Attwenger1 and K. Knahr, MD1

1 Department II (M.P. and K.K.) and Laboratory of Gait and Human Movement (A.K. and B.A.), Orthopedic Hospital Vienna—Speising, Speisingerstrasse 109, A-1130 Vienna, Austria. E-mail address for M. Pospischill: martin.pospischill{at}oss.at. E-mail address for A. Kranzl: andreas.kranzl{at}oss.at. E-mail address for B. Attwenger: bernhard.attwenger{at}oss.at. E-mail address for K. Knahr: karl.knahr{at}oss.at

Investigation performed at the Orthopedic Hospital Vienna—Speising, Vienna, Austria

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Background Minimally invasive total hip arthroplasty is purported to allow an improved and faster rehabilitation in the immediate postoperative period because of reduced soft-tissue damage compared with total hip arthroplasty performed with use of a standard approach. In the present study, a minimally invasive approach was compared with a traditional standard approach in terms of the effect on gait kinematics as demonstrated with gait analysis and electromyography.

Methods Twenty randomized patients who underwent a primary total hip replacement with use of a minimally invasive modified Watson-Jones approach (minimally invasive group) were compared with a group of twenty patients who underwent a total hip arthroplasty with use of a standard transgluteal Hardinge approach (standard group). All patients received the same cementless implant, inserted with use of standard instruments, and all operations were performed by a single, experienced surgeon. The patients were evaluated with use of three-dimensional gait analysis and dynamic electromyograms at three time points: preoperatively, ten days postoperatively, and twelve weeks postoperatively. Temporospatial and joint-kinematic parameters were evaluated.

Results There were no significant differences between the two groups with regard to the temporospatial variables of velocity, cadence, step length, and stride length at any tested time point. With regard to the range of motion of the operatively treated hip, the minimally invasive group had a smaller decrease at the ten-day time point in comparison with the standard group. However, this finding was not significant. The reduction in the range of motion was mainly caused by reduced hip extension. A compensatory increase in the pelvic tilt was observed in both groups. One patient in the standard group showed a positive Trendelenburg gait ten days postoperatively; it had disappeared completely at the twelve-week time point.

Conclusions With regard to gait kinematics in the early postoperative period (three months), the present study showed no significant benefit for patients who underwent a total hip arthroplasty through a minimally invasive Watson-Jones approach in comparison with those who were managed with a standard transgluteal approach.

Level of Evidence Therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?