Comparison of gait parameters in patients following total hip arthroplasty with a direct-lateral or antero-lateral surgical approach

Total hip arthroplasty is a surgical procedure that usually results in almost complete pain relief and early improvement in functional capacity. Previous analyses of the gait of total hip arthroplasty patients have ignored the effect of total hip arthroplasty on the motion of other joints in the operated and non-operated limbs and of the pelvis. We investigated the spatiotemporal, angular, and kinetic parameters of affected and non-affected limbs pre-operatively and after three, six, and twelve months in 40 patients who underwent total hip arthroplasty via a direct-lateral approach, 40 patients who underwent an antero-lateral approach, and 40 age-matched healthy controls. In both patient groups pre-operatively, significant differences were observed in the spatiotemporal, angular, and kinetic parameters comparing the affected and the non-affected side; affected hip motion decreased, which was compensated by increased knee and hip motion of the non-affected side as well as pelvis obliquity and flexion-extension compared to healthy controls. Twelve months after total hip arthroplasty, direct-lateral patients displayed limited hip motion and increased pelvis rotation, while all antero-lateral patients exhibited gait patterns that most resembled the control group. This investigation has therefore identified a better functional outcome following an antero-lateral approach to total hip arthroplasty.

► We compared patient gait after total hip arthroplasty by two approaches with controls.
► Spatiotemporal, angular, and kinetic gait parameters were analyzed.
► Hip motion was limited by the direct-lateral and not the antero-lateral approach.
► Pelvis motion critically compensates during the pre- and post-operative periods.