09/24/2025
Had a hip replacement and still walking funny....Here's why?
Total hip arthroplasty or Total hip replacement involves replacement of femoral head and neck, as well as the acetabulum. It can be done via anterior approach or posterior approach.
Direct anterior (becoming more common):
Incision along anterior hip, proximal and distal to ASIS
Split TFL, move aside re**us femoris and sartorius
Posterior:
Incision along posterolateral hip
Split fibers of gluteus maximus, detach short external rotators
Research shows:
Six months post-op:
Ewen et al. did systematic review and meta-analysis of 7 articles comparing gait variables of THA patients to healthy controls and found decreases in speed, stride length, sagittal hip ROM, peak abduction moment in the involved hip.
Friesenbichler et al. compared explosive strength of involved and uninvolved limb in 21 patients and found asymmetry in explosive strength of hip flexors, extensors, adductors, and abductors (lower on surgical limb).
Not gait directly, but how is explosive strength important for gait? balance
One year post-op:
Bahl et al. performed systematic review and meta-analysis of 74 studies and 2,477 patients and looked at deficits at different time periods.
At one-year post-op: patients still demonstrated deficits in walking speed, stride length, single limb support time, and sagittal plane hip ROM as compared to healthy individuals.
At ten years post-op:
Bennet et al. performed gait analysis of 134 patients and found hip extension and external rotation moments significantly reduced, as well as hip power generation.
