GAIT ANALYSIS AFTER TOTAL HIP ARTHROPLASTY
Comparison between the anterior and posterolateral approach. A pilot study.

Total hip arthroplasty (THA) remains one of the most successful orthopaedic
interventions of the last decades, with 10-year survival now exceeding 95%.
Because of the ageing and the increasing obesity in Western societies, it is
expected that the number of THAs will only rise in the future. Driven by this
growing demand for THA, together with a greater emphasis on cost-effectiveness
in health care and patients* higher expectations of shorter hospital stays and
faster recovery, alternative surgical procedures have been developed to improve
the success of THA. The anterior approach for THA is one of these developments.
Compared to conventional approaches for THA, such as the posterolateral
approach, the anterior approach for THA is considered to result in less damage
to soft tissues, such as muscles and tendons, during surgery in order to
enhance postoperative recovery and, consequently, in an accelerated return to
normal daily functioning. To assess whether the proposed increase in muscle
damage is of any clinical influence, gait analysis can be performed. Gait
analysis is the most reliable way to measure patients* function
postoperatively. Furthermore, muscle activity measurements can be used to
identify any existing differences. However, there is a lack of evidence on the
best way to assess muscle damage after THA.

To conduct a pilot study to determine the best way to analyse gait and muscle
function following anterior and posterolateral approach for THA.

A prospective non-randomized pilot study will be performed. The patients will
be allocated to undergo THA by either the anterior of the posterolateral
approach. The choice for approach will be made by the treating orthopaedic
surgeon in close dialogue with the

Patients in the study group will undergo THA using the minimally invasive
single-incision anterior approach. This approach will be compared to the
conventional posterolateral approach.

Since both the anterior and posterolateral approach for THA are standard
approaches for THA, no additional risks are associated with participation of
the study. With gait function, walking pattern of the patients is assessed.
Patients do not have to perform motor tasks which they are not used to perform.
Furthermore, no invasive procedures are performed during motion analysis and
EMG measurements. So no risks are involved with the gait function measurements.