Gait analysis in patients after bilateral versus unilateral total hip arthroplasty

Federico Temporiti; Giulia Zanotti; Roberta Furone; Sara Molinari; Matteo Zago; Mattia Loppini; Manuela Galli; Guido Grappiolo; Roberto Gatti

doi:10.1016/j.gaitpost.2019.05.026

Gait analysis in patients after bilateral versus unilateral total hip arthroplasty

Gait Posture. 2019 Jul:72:46-50. doi: 10.1016/j.gaitpost.2019.05.026. Epub 2019 May 23.

Authors

Federico Temporiti¹, Giulia Zanotti², Roberta Furone³, Sara Molinari⁴, Matteo Zago⁴, Mattia Loppini⁵, Manuela Galli⁴, Guido Grappiolo⁵, Roberto Gatti⁶

Affiliations

¹ Physiotherapy Unit, Humanitas Clinical and Research Center, Rozzano, Milan, Italy; Humanitas University, Pieve Emanuele, Milan, Italy.
² Physiotherapy Unit, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
³ BTS S.p.A., Garbagnate Milanese, Milan, Italy.
⁴ Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
⁵ Hip and Knee Orthopaedic Surgery Department, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
⁶ Physiotherapy Unit, Humanitas Clinical and Research Center, Rozzano, Milan, Italy; Humanitas University, Pieve Emanuele, Milan, Italy. Electronic address: roberto.gatti@hunimed.eu.

PMID: 31136942
DOI: 10.1016/j.gaitpost.2019.05.026

Abstract

Background: Gait abnormalities were reported in patients after total hip arthroplasty (THA). One-stage bilateral THA was introduced for bilateral hip pathologies, showing similar clinical and surgical outcome to unilateral procedure. However, no studies analyze the gait features after bilateral THA surgery compared to unilateral THA.

Research question: Are there differences in gait characteristics between bilateral and unilateral THA patients and are there differences between these cases and asymptomatic age-matched healthy subjects?

Methods: In this prospective observational study, thirty-five patients with bilateral (n = 18) or unilateral THA (n = 17) and twenty asymptomatic age-matched volunteers were studied. Participants underwent three-dimensional gait analysisin order to detect gait spatial-temporal and kinematic (Gait Variable Score - GVS) parameters. Mobility (Timed Up and Go - TUG), fear of movement (Tampa Scale of Kinesiophobia - TSK) and pain during walking (Numeric Rating Scale - NRS) were also assessed. Patients were evaluated the day before surgery and at seven days, whereas healthy subjects underwent a single evaluation. ANOVA was used to assess differences between the three groups at each time-point and within-group differences in bilateral and unilateral groups.

Results: At baseline, no differences between the two groups of patients were found. As expected, their gait spatial-temporal and kinematic parameters and functional variables were impaired with respect to healthy subjects, both before and after surgery. After surgery, GVS Pelvic-TILT closer to normative values, longer stance and shorter swing phases were found in bilateral cases compared to unilateral patients. Moreover, a higher NRS score was found in bilateral patients, whereas TUG and TSK revealed no differences between the two groups of patients.

Significance: The current findings, focusing on short-term effectiveness of bilateral THA, could assist physiotherapists in selecting the best ambulation training and an appropriate rehabilitation approach immediately after surgery.

Keywords: Functional recovery; Gait analysis; Kinematics; Total hip arthroplasty.

Publication types

Observational Study

MeSH terms

Aged
Arthroplasty, Replacement, Hip / methods*
Biomechanical Phenomena / physiology*
Case-Control Studies
Female
Gait Analysis*
Humans
Lower Extremity / physiopathology*
Male
Middle Aged
Osteoarthritis, Hip / physiopathology
Osteoarthritis, Hip / surgery
Prospective Studies