Functional recovery of muscles after minimally invasive total hip arthroplasty
Ward SR, Jones RE, Long WT, Thomas DJ, Dorr LD.
Instr Course Lect, 2008 57:249-54.
Whether mini-incision total hip arthroplasty is associated with accelerated
postoperative recovery is a subject of considerable controversy. A study was
conducted to compare objective outcomes using gait analysis as a measure for
recovery of function in patients treated with three different minimally invasive
surgical approaches and the traditional posterior approach. Sixty-nine patients
underwent instrumented gait analysis at self-selected and fast velocities
preoperatively and at 6 weeks and 3 months postoperatively. Four surgical groups
were studied-30 treated with posterior mini-incisions, 11 anterolateral, 10
anterior Judet, and 18 traditional posterior long incisions. Overall, gait
velocity increased slightly at 6 weeks and significantly at 3 months. However,
there were no significant differences between groups for velocity, cadence,
stride length, single-limb support time, or double-limb support time at 6 weeks
or 3 months postoperatively. These data indicate that patients undergoing total
hip arthroplasty with any of these surgical approaches recover muscle function,
as measured by gait analysis, to preoperative levels within 6 weeks
postoperatively. No advantage was shown with the use of any of the three
different small-incision approaches. This finding suggests that the amount of
muscle, or the particular muscle cut, does not have a significant effect on the
recovery of postoperative gait function.