Early clinical evaluation of total hip arthroplasty by three-dimensional gait analysis and muscle strength testing

•In healthy persons, the walking trajectory is symmetrical and forms a butterfly pattern.•The walking trajectory in patients with osteoarthritis of the hip was not normal.•An abnormality of the trajectory tended to persist postoperative 3 months after THA.•A portable gait rhythmograph (PGR) is usefu...

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Bibliographic Details
Published in:Gait & posture 2018-10, Vol.66, p.214-220
Main Authors: Gomi, Motosi, Maezawa, Katsuhiko, Nozawa, Masahiko, Yuasa, Takahito, Sugimoto, Munehiko, Hayashi, Akito, Mikawa, Saiko, Kaneko, Kazuo
Format: Article
Language:English
Subjects:
Clinical evaluation
Dynamic three-dimensional gait analysis
Hip muscle strength
Portable gait rhythmograph (PGR)
Total hip arthroplasty (THA)
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Summary:•In healthy persons, the walking trajectory is symmetrical and forms a butterfly pattern.•The walking trajectory in patients with osteoarthritis of the hip was not normal.•An abnormality of the trajectory tended to persist postoperative 3 months after THA.•A portable gait rhythmograph (PGR) is useful for investigating gait abnormality. As improvement of gait is an important reason for patients to undergo total hip arthroplasty (THA) and they generally tend to evaluate its success based on postoperative walking ability, objective functional evaluation of postoperative gait is important. However, the patient’s normal gait before osteoarthritis is unknown and the changes that will occur postoperatively are unclear. We investigated the change in gait and hip joint muscle strength after THA by using a portable gait rhythmograph (PGR) and muscle strength measuring device. The subjects were 46 women (mean age: 65.9 years) with osteoarthritis of the hip. Gait analysis and muscle strength testing were performed before THA, as well as 3 weeks and 3 months after surgery. We measured the walking speed, step length, and gait trajectory using PGR prospectively. PGR is attached to the patient’s waist and records signals at a sampling rate of 100 Hz. Isometric torque of hip flexion and abduction were measured by using a hand-held dynamometer. There was no improvement at 3 weeks postoperatively, but the walking speed, stride length and muscle strength were clearly showed improvement at 3 months postoperatively. The walking trajectory was not normal preoperatively, since the trajectory was not symmetrical and did not intersect in the midline or form a butterfly pattern, and abnormality of the trajectory tended to persist postoperative 3 months despite resolution of hip joint pain after surgery. Since postoperative improvement of gait is an important consideration for patients undergoing THA, it seems relevant to evaluate changes in the gait after surgery and three-dimensional analysis with a PGR may be useful for this purpose.
ISSN:0966-6362
1879-2219
DOI:10.1016/j.gaitpost.2018.08.037