Rehabilitation of gait in patients after total hip arthroplasty: Comparison of the minimal invasive Yale 2-incision technique and the conventional lateral approach |
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| Affiliation: | 1. Orthopaedic Hospital for Children, Behandlungszentrum Aschau, Germany;2. Wolfart Clinic Gräfelfing, Department Orthopaedics and Endoprothetics, Germany;3. Social-pediatric center in Munich, Germany;4. Siegfried Weller Institute for Trauma Research, BG Trauma Center Tübingen, Eberhard Karls University of Tübingen, Germany;1. Division of Sports Medicine and Hip Preservation, Department of Orthopaedics, University of Colorado, Denver, Colorado, U.S.A.;2. Melbourne Orthopaedic Group, Melbourne, Victoria, Australia;1. Department of Orthopaedics, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria;2. Department of Pathology, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria;1. Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, Bristol BS10 5NB, UK;2. National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK;1. Rehabilitation Sciences Program, College of Health Sciences, University of Kentucky, 900 S. Limestone, Lexington, KY 40536-0200, USA;2. Department of Orthopaedics & Sports Medicine, College of Medicine, University of Kentucky, 125 E. Maxwell Street, Suite 201, Lexington, KY 40508, USA;3. Division of Physical Therapy, College of Health Sciences, University of Kentucky, Room 204D Wethington Building, 900 South Limestone St, Lexington, KY 40536, USA |
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| Abstract: | The minimal invasive anterolateral Yale 2-incision approach for total hip arthroplasty aims minimizing damage to the muscles for faster recovery of function. Therefore the hypothesis was investigated, that during the rehabilitation process the Yale approach shows a faster return to natural gait than a conventional lateral approach.Nineteen patients had the Yale, 16 the conventional Bauer approach. Instrumented gait analysis was performed 3 days, 3 and 12 month post operatively. Velocity, cadence, step length, weight bearing, thorax lean, Trendelenburg limp, hip abduction moments, and hip muscle activation times were evaluated.Three days post-surgery a significantly greater loading of the treated limb and increased hip abduction moment were observed in the Yale group. In addition, the Yale group showed its greatest improvement in walking speed and step length between at 3 days and 3 months, whereas the conventional group showed an additional significant gain between 3 and 12 month to reach a similar walking speed as the Yale group. For all hip muscles investigated, only muscle tensor fasciae latae in the conventional group showed a significant increase in activation time between 3 days and 3 months.This study showed significantly faster return to natural gait in the Yale compared to the conventional approach, which could be biomechanically related to less impairment of abductor muscles in the Yale approach. |
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| Keywords: | Hip arthroplasty Yale-technique 2 incision approach MIS hip surgery Gait Rehabilitation THA" },{" #name" :" keyword" ," $" :{" id" :" kw0040" }," $$" :[{" #name" :" text" ," _" :" Total hip Arthroplasty HC" },{" #name" :" keyword" ," $" :{" id" :" kw0050" }," $$" :[{" #name" :" text" ," _" :" Healthy controls MIS" },{" #name" :" keyword" ," $" :{" id" :" kw0060" }," $$" :[{" #name" :" text" ," _" :" Minimal invasive surgery CON" },{" #name" :" keyword" ," $" :{" id" :" kw0070" }," $$" :[{" #name" :" text" ," _" :" Conventional surgery |
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