Document Detail


No strength or gait benefit of two-incision THA: a brief followup at 1 year.
MedLine Citation:
PMID:  21076897     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Using comprehensive gait analysis and strength testing, we previously investigated the early (2-month) functional outcome after THA using two-incision and mini-posterior surgical approaches and found an advantage for the mini-posterior approach. Benefits included improved muscle strength, a less antalgic gait, and better hip function as reflected by changes in hip moments during level walking and stair climbing. We questioned how these differences in function would fare with longer followup.
QUESTIONS/PURPOSES: We determined whether the observed early functional advantages for the mini-posterior technique over the two-incision technique were still present 1 year postoperatively.
PATIENTS AND METHODS: We prospectively enrolled 22 patients with primary degenerative arthritis of the hip; of these, 21 completed gait and strength testing at 2 months, and 19 completed comprehensive gait and strength testing at 1 year (11 two-incision hips, eight mini-posterior hips). The 19 patients included 11 men and eight women with a mean age of 65 years (range, 40-85 years) and a mean (BMI) of 29 (range, 21-39).
RESULTS: At 1 year postoperatively, the patients who had the mini-posterior THA had greater improvement in hip flexion strength and internal rotation strength, greater increase in hip flexor internal moment, and greater increase in single-leg stance time on level ground over the patients who had the two-incision THA.
CONCLUSIONS: Compared with the two-incision approach, patients undergoing mini-posterior THA had persistently better function, including hip flexor and internal rotator muscle strength, hip flexor internal moment, and single-leg stance during level walking.
LEVEL OF EVIDENCE: Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Authors:
Aaron J Krych; Mark W Pagnano; Krista Coleman Wood; R Michael Meneghini; Kenton Kaufman
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2010-11-13
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-04     Completed Date:  2011-05-12     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1110-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip / methods*
Biomechanics
Female
Gait*
Hip Joint / physiopathology,  surgery*
Humans
Male
Middle Aged
Minnesota
Muscle Strength*
Prospective Studies
Range of Motion, Articular
Recovery of Function
Time Factors
Torque
Treatment Outcome
Walking
Comments/Corrections

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