Gait Analysis of Patients after Primary Total Hip Arthroplasty with Lateral Decubitus Direct Anterior Approach and Anterolateral Approach
Objective:To compare the gait changes of patients after primary unilateral total hip arthroplasty(THA)with lateral decubitus direct anterior approach(DAA)and anterolateral approach(ALA)by gait analysis technique,in order to explore the difference of postoperative rehabilitation effect between the two approaches.Methods:A total of 120 patients who met the inclusion and exclusion criteria were selected.All the patients were admitted from April 2020 to November 2022.The hip replacement with two different approaches was performed by the same physician.According to different sur-gical approaches,patients were divided into DAA group(60 cases)and ALA group(60 cases)by random number table method.Operation time,incision length,blood loss,visual analogue scale(VAS)score and Harris hip function score were compared between the two groups.Gait frequency,stride speed,stride length and intraoperative support phase were com-pared between the two groups before operation and 3 d,2 months and 4 months after operation.Results:Compared with ALA group,DAA group had shorter operation time,shorter inci-sion length and less blood loss(P<0.05).VAS scores of DAA group,1 d,3 d and 2 months after surgery were significantly low-er than those of ALA group(P<0.05).Harris scores of DAA group,1 d,3 d and 2 months after surgery were higher than those of ALA group(P<0.05).Intra-group comparison,step frequency,step speed,stride length and intraoperative support phase of patients in DAA group and ALA group were significantly recovered 3 d after surgery compared with that before surgery(P<0.05).There were statistically significant differences in step frequency,step speed,stride length and intraoperative support between DAA group and ALA group 3 d and 2 months after surgery(P<0.05),while there were no statistically significant differences in step frequency,step speed,stride length and intraoperative support between DAA group and ALA group 4 months after surgery(P>0.05).Conclusion:Both the direct anterior approach and the anterolateral approach improved gait significantly after primary unilateral total hip arthroplasty,and gait recovery was faster with the direct anterior approach.
lateral decubitus positiondirect anterior approachanterolateral approachtotal hip arthroplastyfemoral head necrosisgait analysisfemoral head necrosis