Clinical Orthopaedics and Related Research®

, Volume 471, Issue 12, pp 3830–3837

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

  • Luigi Zagra
  • Federica Anasetti
  • Luca Bianchi
  • Vittorio Licari
  • Roberto Giacometti Ceroni
Symposium: 2012 International Hip Society Proceedings

DOI: 10.1007/s11999-013-2926-6

Cite this article as:
Zagra, L., Anasetti, F., Bianchi, L. et al. Clin Orthop Relat Res (2013) 471: 3830. doi:10.1007/s11999-013-2926-6

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.

Copyright information

© The Association of Bone and Joint Surgeons® 2013

Authors and Affiliations

  • Luigi Zagra
    • 1
  • Federica Anasetti
    • 2
  • Luca Bianchi
    • 1
  • Vittorio Licari
    • 3
  • Roberto Giacometti Ceroni
    • 1
  1. 1.Hip DepartmentIRCCS Istituto Ortopedico GaleazziMilanItaly
  2. 2.Motion Analysis LaboratoryIRCCS Istituto Ortopedico GaleazziMilanItaly
  3. 3.Rehabilitation Unit IRCCS Istituto Ortopedico GaleazziMilanItaly