Ergebnisse aus Messungen der Bodenreaktionskraft vor und nach Implantation einer Hüfttotalendoprothese bei unterschiedlichen Operationszugängen

Abstract

Benefits of less damage of soft tissues and muscles in minimally invasive hip replacement lead to expectations of better results in gait rehabilitation. The aim of the study is to evaluate post-operative walking ability in terms of different surgical approaches. 16 patients underwent a minimally invasive total hip replacement (MIS group) and 16 other patients got a THA using a transgluteal approach (standard group). Differences in functional indices of ground reaction forces and symmetry indices were measured one day pre-operatively as well as 8, 14 and 28 weeks post-operatively. The results were compared between the surgical approaches and to an age-matched healthy control group. There are significantly reduced pain symptoms and a higher functional ability in both surgical groups 8 weeks post-operatively. There are no differences in gait parameters between the surgical groups after 28 weeks. Trends in gait velocity, temporal parameters and in functional indices of ground reaction forces show advantages for the minimally invasive group 8 and 14 weeks post-operatively. Patients do not reach the age-matched control group. Obviously the immediate post-operative advantages of minimally invasive hip replacement provide better chances for gait rehabilitation compared to the transgluteal approach. Due to the complexity of the problem clinical and gait analysis studies should be linked more closely.