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Clin Biomech (Bristol, Avon). 2019 Jul;67:166-170. doi: 10.1016/j.clinbiomech.2019.05.007. Epub 2019 May 9.

No difference in gait kinematics or kinetics between limbs in bilateral total hip replacement patients at long-term follow-up.

Author information

1
Outcomes Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, United Kingdom. Electronic address: nicola.gallagher@belfasttrust.hscni.net.
2
Outcomes Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, United Kingdom. Electronic address: robert.brucebrand@belfasttrust.hscni.net.
3
Outcomes Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, United Kingdom. Electronic address: damien.bennett@hscni.net.
4
Outcomes Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, United Kingdom. Electronic address: seamus.obrien@belfasttrust.hscni.net.
5
Outcomes Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, United Kingdom. Electronic address: david.beverland@belfasttrust.hscni.net.

Abstract

BACKGROUND:

Previous studies report that gait parameters of patients following total hip replacement improve from pre-operative levels, although in most cases do not reach those of normal subjects. However, studies are generally of unilateral total hip replacement patients at short-term follow-up. There have been no reports of 3D gait kinematics and kinetics in patients with bilateral total hip replacements at long-term follow-up. The aim of this study was to compare temporospatial parameters and 3D lower limb gait kinematics and kinetics at long-term follow-up between limbs and against controls for patients who have undergone staged bilateral total hip replacement.

METHODS:

3D gait analysis was performed on 13 patients who had undergone bilateral total hip replacement, at an average follow-up of 10.1 (first hip) and 9.3 years (second hip), and a normal elderly control group comprising 10 subjects.

FINDINGS:

Knee flexion/extension range of motion was marginally greater in Hip 2 (p = 0.049) compared to Hip 1 by 3.2°. There were no other significant differences in temporospatial parameters or a range of lower limb kinematics or kinetics between the first and second operated hip. Multiple gait parameters were significantly worse for both hips compared to age-matched normal individuals.

INTERPRETATION:

Although symmetrical biomechanical recovery was achieved, significant gait deficiencies remain in both hips compared to normal controls. These deficits may provide targets for enhanced rehabilitation programs.

KEYWORDS:

Bilateral; Gait analysis; Hip replacement; Long-term follow-up

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