, Volume 471, Issue 12, pp 3830-3837
Date: 03 May 2013

No Difference in Gait Recovery After THA With Different Head Diameters: A Prospective Randomized Study

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Topic
Hip

Abstract

Background

Larger femoral heads are commonly presumed to improve joint stability and hip biomechanics; some studies have suggested they may hasten recovery of a normal gait. To our knowledge, no gait analysis studies have compared different size head diameters in THA.

Questions/purposes

We compared (1) spatiotemporal gait parameters, (2) kinematic and kinetic gait parameters, and (3) Harris hip scores in patients undergoing THA randomized to receive a 28-, 36-, or ≥ 42-mm bearing couple. We hypothesized a larger femoral head would restore an earlier, more physiologic gait pattern.

Methods

This randomized, blinded study involved 60 patients who received the same cementless THA except for the size of the bearing. Inclusion criteria were primary hip arthritis, female sex, and age between 55 and 70 years. Exclusion criteria were other problems influencing walking ability. The patients were randomized into three groups of 20 each (28- and 36-mm ceramic-on-crosslinked polyethylene, ≥ 42-mm metal-on-metal). All patients underwent the same postoperative rehabilitation protocol. Gait evaluation using an optoelectronic system was performed preoperatively and at 2 and 4 months postoperatively.

Results

With the numbers available, no differences in spatiotemporal gait parameters, kinematic or kinetic gait parameters, or Harris hip scores emerged among the three groups. All variables assessed at 4 months postoperatively showed improvements across all groups, but the differences among them were not significant.

Conclusions

The hypothesis that a larger femoral head results in improved early gait performance was not supported by this study.

Level of Evidence

Level I, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

During the study period, the institution of the authors received funding from Lima Corp (San Daniele del Friuli, Italy). Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.
Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use.
Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.