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G-40 Free Communication/Poster - Running Mechanics Saturday, June 4, 2016, 7: 30 AM - 11: 00 AM Room: Exhibit Hall A/B

Short Term Recovery of Walking Gait Following Direct Anterior Total Hip Arthroplasty

3848 Board #287 June 4, 8

00 AM - 9

30 AM

Vogelpohl, Rachele E.; Kimura, Iris F.; Stickley, Christopher D.; Hetzler, Ronald K. FACSM; Nakasone, Cass

Author Information
Medicine & Science in Sports & Exercise: May 2016 - Volume 48 - Issue 5S - p 1080-1081
doi: 10.1249/01.mss.0000488251.50292.3e
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The direct anterior (DA) total hip arthroplasty (THA) is a minimally invasive procedure that accesses the hip joint from the anterior aspect of the hip by retracting instead of incising anterior hip musculature during surgery. During this procedure, little to no damage occurs to the hip abductors and extensors, and as a result is theorized to result in an accelerated return to normal function.

PURPOSE: To prospectively investigate gait biomechanics following DA THA to identify the short term recovery and time sequence of return to normal gait.

METHODS: Nine participants undergoing DA THA (64.1±9 y, 1.7±0.1 m, 72.5±10.8 kg) and nine control participants (60.7±4.3 y, 1.7±0.1 m, 71.4±5.5 kg), completed walking gait trials prior to and at three and six weeks following DA THA surgery. At each session, gait biomechanics at the hip were collected via three-dimensional motion capture system and force plates.

RESULTS: Individual two-way repeated measures ANOVA revealed significant biomechanical differences in walking gait between the DA THA and the control groups at pre-surgery, and at three and six weeks following surgery. At pre operation and three weeks post operation, max hip extension (pre: p<0.001, 10.4±10.3; 3 wk post: p=0.005, 3.9±10.7), hip flexion/extension excursion (pre: p<0.001. -20.1±9.8; 3 wk post: p<0.001, -26.85±7.6), hip abduction/adduction excursion (pre: p=0.001, -2.63±2.0, 3 wk post: p=0.02, -4.65±2.24), hip extension moment (pre: p<0.001, -557.3±309.2, 3 wk post: p<0.001, -677.1±215.0) and hip internal rotation moment (pre: p<0.001, 41.89±27.6, 3 wk post: p<0.001, 54.6±31.1) were all significantly less in the DA THA group than the control group. By six weeks post operation, only hip flexion/extension excursion (p<0.001, -33.5±4.3) and hip abduction/adduction excursion (p=0.01, -3.6±2.1) remained significantly lower in the DA THA group.

CONCLUSIONS: Short term analysis following DA THA revealed impairments in walking gait at pre operation, and at three and six weeks post operation. By six weeks post operation however, many improvements were made in walking gait when compared to the previous sessions. It appears that the participants began to return to normal function, but a longer follow-up time may be necessary to determine if these DA THA participants completely return to normal walking gait.

© 2016 American College of Sports Medicine