Skip to main content

Advertisement

SpringerLink
Log in

Kinematic Gait Analysis After Primary Total Hip Replacement: A Systematic Review

Gait After Total Hip Replacement: A Systematic Review

  • Review Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Total hip replacement (THR) is a surgical procedure indicated for patients affected by severe hip osteoarthritis. Although this technique has proved to be effective in relieving pain and restoring function, gait limitations may persist following this procedure. The objective of this systematic review was to evaluate gait kinematics after THR and compare the results with those of the pre-operative state and with healthy control individuals. PubMed/MEDLINE, Embase, Web of Science, CENTRAL and Scopus databases were searched until December 2019. Methodological quality and internal validity score of each study were assessed using the PEDro and the Newcastle–Ottawa scales. In all, ten studies met our inclusion criteria. Following THR, statistically significant improvements were seen in dynamic hip and knee range of motion of both the affected and the contralateral limb, single-limb support time symmetry, step length, stride length, walking speed and gait pattern. However, deficits were observed in all the previous parameters, as well as in hip adduction angle in comparison with healthy subjects. In conclusion, gait patterns improve after THR in comparison with the pre-operative state, although there are deficits relative to healthy individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Siopack, J. S., & Jergesen, H. E. (1995). Total hip arthroplasty. Western Journal of Medicine, 162, 243–249.

    CAS  PubMed Central  Google Scholar 

  2. Fortina, M., Carta, S., Gambera, D., Crainz, E., Ferrata, P., & Maniscalco, P. (2005). Recovery of physical function and patient’s satisfaction after total hip replacement (THR) surgery supported by a tailored guide-book. Acta Biomed, 76, 152–156.

    PubMed  Google Scholar 

  3. Gogia, P. P., Christensen, C. M., & Schmidt, C. (1994). Total hip replacement in patients with osteoarthritis of the hip: improvement in pain and functional status. Orthopedics, 17, 145–150.

    CAS  PubMed  Google Scholar 

  4. Liu, X. W., Zi, Y., Xiang, L. B., & Wang, Y. (2015). Total hip arthroplasty: areview of advances, advantages and limitations. Int J Clin Exp Med, 8, 27–36.

    PubMed  PubMed Central  Google Scholar 

  5. Kolk, S., Minten, M. J. M., van Bon, G. E. A., Rijnen, W. H., Geurts, A. C., Verdonschot, N., et al. (2014). Gait and gait-related activities of daily living after total hip arthroplasty: a systematic review. Clin Biomech (Bristol, Avon), 29, 705–718.

    Google Scholar 

  6. Wylde, V., Blom, A., Dieppe, P., Hewlett, S., & Learmonth, I. (2008). Return to sport after joint replacement. Journal of Bone and Joint Surgery. British Volume, 90, 920–923.

    CAS  Google Scholar 

  7. Perron, M., Malouin, F., Moffet, H., & McFadyen, B. J. (2000). Three-dimensional gait analysis in women with a total hip arthroplasty. Clin Biomech (Bristol, Avon), 15, 504–515.

    CAS  Google Scholar 

  8. Vogt, L., Brettmann, K., Pfeifer, K., & Benzer, W. (2003). Walking patterns of hip arthroplasty patients: some observations on the medio-lateral excursions of the trunk. Disability and Rehabilitation, 25, 309–317.

    CAS  PubMed  Google Scholar 

  9. McCrory, J. L., White, S. C., & Lifeso, R. M. (2001). Vertical ground reaction forces: objective measures of gait following hip arthroplasty. Gait Posture, 14, 104–109.

    CAS  PubMed  Google Scholar 

  10. Talis, V. L., Grishin, A. A., Solopova, I. A., Oskanyan, T. L., Belenky, V. E., & Ivanenko, Y. P. (2008). Asymmetric leg loading during sit-to-stand, walking and quiet standing in patients after unilateral total hip replacement surgery. Clinl Biomech, 23, 424–433.

    CAS  Google Scholar 

  11. Cichy, B., Wilk, M., & Sliwiński, Z. (2008). Changes in gait parameters in total hip arthroplasty patients before and after surgery. Medical Science Monitor, 14(3), CR159–CR169.

    PubMed  Google Scholar 

  12. Bahl, J. S., Nelson, M. J., Taylor, M., Solomon, L. B., Arnold, J. B., & Thewlis, D. (2018). Biomechanical changes and recovery of gait function after total hip arthroplasty for osteoarthritis: a systematic review and meta-analysis. Osteoarthr Cartil, 26, 847–863.

    CAS  Google Scholar 

  13. Foucher, K. C., & Freels, S. (2015). Preoperative factors associated with postoperative gait kinematics and kinetics after total hip arthroplasty. Osteoarthr Cartil, 23(10), 1685–1694.

    Google Scholar 

  14. Lugade, V., Wu, A., Jewett, B., Collis, D., & Chou, L. S. (2010). Gait asymmetry following an anterior and anterolateral approach to total hip arthroplasty. Clinical Biomechanics, 25, 675–680.

    PubMed  Google Scholar 

  15. Meneghini, R. M., Smits, S. A., Swinford, R. R., & Bahamonde, R. E. (2008). A randomized, prospective study of 3 minimally invasive surgical approaches in total hip arthroplasty. Journal of Arthroplasty, 23, 68–73.

    Google Scholar 

  16. Leardini, A., Chiari, L., Della Croce, U., & Cappozzo, A. (2005). Human movement analysis using stereophotogrammetry. Part 3. Soft tissue artifact assessment and compensation. Gait Posture, 21, 212–225.

    PubMed  Google Scholar 

  17. Mukaino, M., Ohtsuka, K., Tanikawa, H., et al. (2018). Clinical-oriented three-dimensional gait analysis method for evaluating gait disorder. J Vis Exp, 133, 57063.

    Google Scholar 

  18. Baker, R. (2006). Gait analysis methods in rehabilitation. J Neuroeng Rehabil, 3, 4.

    PubMed  PubMed Central  Google Scholar 

  19. Ewen, A. M., Stewart, S., StClairGibson, A., Kashyap, S. N., & Caplan, N. (2012). Post-operative gait analysis in total hip replacement patients—A review of current literature and meta-analysis. Gait Posture, 36, 1–6.

    PubMed  Google Scholar 

  20. Panic, N., Leoncini, E., de Belvis, G., Ricciardi, W., & Boccia, S. (2013). Evaluation of the endorsement of the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement on the quality of published systematic review and meta-analyses. PLoS ONE, 8, e83138.

    PubMed  PubMed Central  Google Scholar 

  21. Booth, A., Clarke, M., Dooley, G., Ghersi, D., Moher, D., Petticrew, M., et al. (2012). The nuts and bolts of PROSPERO: an international prospective register of systematic reviews. Syst Rev, 1, 2.

    PubMed  PubMed Central  Google Scholar 

  22. Sherrington, C., Herbert, R. D., Maher, C. G., & Moseley, A. M. (2000). PEDro. A database of randomized trials and systematic reviews in physiotherapy. Man Ther, 5, 223–226.

    CAS  PubMed  Google Scholar 

  23. Wells G, Tugwell P, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses 2011.

  24. Lavigne, M., Therrien, M., Nantel, J., Roy, A., Prince, F., & Vendittoli, P. A. (2010). The John Charnley Award: the functional outcome of hip resurfacing and large-head THR is the same: a randomized, double-blind study. Clinical Orthopaedics and Related Research, 468, 326–336.

    PubMed  Google Scholar 

  25. Foucher, K. C., Wimmer, M. A., Moisio, K. C., Hildebrand, M., Berli, M. C., Walker, M. R., et al. (2011). Time course and extent of functional recovery during the first postoperative year after minimally invasive total hip arthroplasty with two different surgical approaches—a randomized controlled trial. Journal of Biomechanics, 44, 372–378.

    PubMed  Google Scholar 

  26. Foucher, K. C., Hurwitz, D. E., & Wimmer, M. A. (2007). Preoperative gait adaptations persist one year after surgery in clinically well-functioning total hip replacement patients. Journal of Biomechanics, 40, 3432–3437.

    PubMed  Google Scholar 

  27. Nantel, J., Termoz, N., Vendittoli, P. A., Lavigne, M., & Prince, F. (2009). Gait patterns after total hip arthroplasty and surface replacement arthroplasty. Archives of Physical Medicine and Rehabilitation, 90, 463–469.

    PubMed  Google Scholar 

  28. Rosler, J., & Perka, C. (2000). The effect of anatomical positional relationships on kinetic parameters after total hip replacement. International Orthopaedics, 24, 23–727.

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Naili, J. E., Hedström, M., & Broström, E. W. (2019). Changes of and interrelationships between performance-based function and gait and patient-reported function 1 year after total hip arthroplasty. J Orthop Traumatol, 20, 14.

    PubMed  PubMed Central  Google Scholar 

  30. Wesseling, M., Meyer, C., Corten, K., Desloovere, K., & Jonkers, I. (2018). Longitudinal joint loading in patients before and up to one year after unilateral total hip arthroplasty. Gait Posture, 61, 117–124.

    PubMed  Google Scholar 

  31. Foucher, K. C., & Wimmer, M. A. (2012). Contralateral hip and knee gait biomechanics are unchanged by total hip replacement for unilateral hip osteoarthritis. Gait Posture, 35, 61–65.

    PubMed  Google Scholar 

  32. Horstmann, T., Listringhaus, R., Haase, G. B., Grau, S., & Mündermann, A. (2013). Changes in gait patterns and muscle activity following total hip arthroplasty: a six-month follow-up. Clinical Biomechanics, 28, 762–769.

    PubMed  Google Scholar 

  33. Loizeau, J., Allard, P., Duhaime, M., & Landjerit, B. (1995). Bilateral gait patterns in subjects fitted with a total hip prosthesis. Archives of Physical Medicine and Rehabilitation, 76, 552–557.

    CAS  PubMed  Google Scholar 

  34. Bennett, D., Humphreys, L., O’Brien, S., Kelly, C., Orr, J. F., & Beverland, D. E. (2008). Gait kinematics of age-stratified hip replacement patients—a large scale, long-term follow-up study. Gait Posture, 28, 194–200.

    CAS  PubMed  Google Scholar 

  35. Beaulieu, M. L., Lamontagne, M., & Beaulé, P. E. (2010). Lower limb biomechanics during gait do not return to normal following total hip arthroplasty. Gait Posture, 32, 269–273.

    PubMed  Google Scholar 

  36. Bennett, D., Humphreys, L., O’Brien, S., Kelly, C., Orr, J. F., & Beverland, D. E. (2009). Temporospatial parameters of hip replacement patients ten years post-operatively. International Orthopaedics, 33, 1203–1207.

    CAS  PubMed  Google Scholar 

  37. Madsen, M. S., Ritter, M. A., Morris, H. H., Meding, J. B., Berend, M. E., Paris, P. M., et al. (2004). The effect of total hip arthroplasty surgical approach on gait. J Orthop Research, 22, 44–50.

    Google Scholar 

  38. Naili, J. E., Esbjörnsson, A. C., Rozumalski, A., Schwartz, M. H., Reimeringer, M., & Broström, E. (2012). Gait deviation index—a suitable measurement of gait deviations in patients with knee and hip osteoarthritis. Gait Posture, 36, S53–S54.

    Google Scholar 

  39. Rosenlund, S., Holsgaard-Larsen, A., Overgaard, S., & Jensen, C. (2016). The gait deviation index is associated with hip muscle strength and patient-reported outcome in patients with severe hip osteoarthritis—a cross-sectional study. PLoS ONE, 11, e0153177.

    PubMed  PubMed Central  Google Scholar 

  40. Sicard-Rosenbaum, L., Light, K. E., & Behrman, A. L. (2002). Gait, lower extremity strength, and self-assessed mobility after hip arthroplasty. J Gerontol Ser A Biol Sci Med Sci, 57, M47–51.

    Google Scholar 

  41. Frost, K. L., Bertocci, G. E., Wassinger, C. A., Munin, M. C., Burdett, R. G., & Fitzgerald, S. G. (2006). Isometric performance following total hip arthroplasty and rehabilitation. Journal of Rehabilitation Research and Development, 43, 435–444.

    PubMed  Google Scholar 

  42. Grimaldi, A., Richardson, C., Durbridge, G., Donnelly, W., Darnell, R., & Hides, J. (2009). The association between degenerative hip joint pathology and size of the gluteus maximus and tensor fascia lata muscles. Man Ther, 14, 611–617.

    PubMed  Google Scholar 

  43. Sutherland, A. G., D’Arcy, S., Smart, D., & Ashcroft, G. P. (1999). Abductor weakness and stresses around acetabular components of total hip arthroplasty: a finite element analysis. International Orthopaedics, 23, 275–278.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. Damm, P., Zonneveld, J., Brackertz, S., Streitparth, F., & Winkler, T. (2018). Gluteal muscle damage leads to higher in vivo hip joint loads 3 months after total hip arthroplasty. PLoS ONE, 13, e0190626.

    PubMed  PubMed Central  Google Scholar 

  45. Kovalak, E., Özdemir, H., Ermutlu, C., & Obut, A. (2018). Assessment of hip abductors by MRI after total hip arthroplasty and effect of fatty atrophy on functional outcome. Acta Orthop Traumatol Turc, 52, 196–200.

    PubMed  PubMed Central  Google Scholar 

  46. Ward, S. R., Winters, T. M., & Blemker, S. S. (2010). The architectural design of the gluteal muscle group: Implications for movement and rehabilitation. J Orthop Sports Phys Therapy, 40, 95–102.

    Google Scholar 

  47. Husby, V. S., Helgerud, J., Bjørgen, S., Husby, O. S., Benum, P., & Hoff, J. (2009). Early maximal strength training is an efficient treatment for patients operated with total hip arthroplasty. Archives of Physical Medicine and Rehabilitation, 90, 1658–1667.

    PubMed  Google Scholar 

  48. Winther, S. B., Foss, O. A., Husby, O. S., Wik, T. S., Klaksvik, J., & Husby, V. S. (2018). A randomized controlled trial on maximal strength training in 60 patients undergoing total hip arthroplasty: implementing maximal strength training into clinical practice. Acta Orthopaed, 89, 295–301.

    Google Scholar 

  49. Wang, A. W., Gilbey, H. J., & Ackland, T. R. (2002). Perioperative exercise programs improve early return of ambulatory function after total hip arthroplasty: a randomized, controlled trial. Am J Physl Med Rehabil, 81, 801–806.

    Google Scholar 

  50. Gilbey, H. J., Ackland, T. R., Wang, A. W., Morton, A. R., Trouchet, T., & Tapper, J. (2003). Exercise improves early functional recovery after total hip arthroplasty. Clin OrthopRelat Res, 408, 193–200.

    Google Scholar 

  51. Komnik, I., Weiss, S., Fantini Pagani, C. H., & Potthast, W. (2015). Motion analysis of patients after knee arthroplasty during activities of daily living—a systematic review. Gait Posture, 41, 370–377.

    CAS  PubMed  Google Scholar 

  52. Cimolin, V., & Galli, M. (2014). Summary measures for clinical gait analysis: a literature review. Gait Posture, 39, 1005–1010.

    PubMed  Google Scholar 

  53. Westhoff B, Hirsch MA, Hefter H, Wild A, Krauspe R. Wie reliabel sind informationen aus der 3d-ganganalyse How reliable are data from 3D-gait analysis. Sportverletzung-Sportschaden 2004; 18: 76–9.

  54. Temporiti, F., Zanotti, G., Furone, R., Molinari, S., Zago, M., Loppine, M., et al. (2019). Gait analysis in patients after bilateral versus unilateral total hip arthroplasty. Gait Posture, 72, 46–50.

    PubMed  Google Scholar 

  55. Vail, T. P., Mina, C. A., Yergler, J. D., & Pietrobon, R. (2006). Metal-on-metal hip resurfacing compares favorably with THR at 2 years followup. Clinical Orthopaedics and Related Research, 453, 123–131.

    PubMed  Google Scholar 

  56. Foucher, K. C., Hurwitz, D. E., & Wimmer, M. A. (2008). Do gait adaptations during stair climbing result in changes in implant forces in subjects with total hip replacements compared to normal subjects? Clinical Biomechanics, 23, 754–761.

    PubMed  Google Scholar 

Download references

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author information

Authors and Affiliations

  1. Department of Cellular Morphology and Biology, Universidad de Oviedo, Oviedo, Spain

    Luis Mendiolagoitia & Miguel del Valle

  2. Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain

    Miguel Ángel Rodríguez, Irene Crespo & Hugo Olmedillas

  3. Institute of Biomedicine, Universidad de León, León, Spain

    Irene Crespo

  4. Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain

    Hugo Olmedillas

Authors
  1. Luis Mendiolagoitia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Miguel Ángel Rodríguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Irene Crespo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Miguel del Valle
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hugo Olmedillas
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

LM and HO contributed to the study conception and design. LM, MAR and HO extracted data from the studies and evaluated the inclusion and exclusion criteria. LM and HO assessed the methodological quality of the studies. All the authors contributed to the interpretation of the data and drafted the manuscript.

Corresponding author

Correspondence to Hugo Olmedillas.

Ethics declarations

Conflict of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Ethical standard statement

This manuscript has been approved by all the authors and represents honest work. This manuscript has not been published and is not under consideration for publication elsewhere.

Informed consent

For this type of study formal consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 16 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mendiolagoitia, L., Rodríguez, M.Á., Crespo, I. et al. Kinematic Gait Analysis After Primary Total Hip Replacement: A Systematic Review. JOIO 54, 767–775 (2020). https://doi.org/10.1007/s43465-020-00101-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43465-020-00101-x

Keywords

Search

Navigation