Early gait analysis after curved periacetabular osteotomy for acetabular dysplasia

Abstract

Masamichi Nishimura,1 Naonobu Takahira,1–3 Kensuke Fukushima,3,4 Takeaki Yamamoto,4 Mitsutoshi Moriya,4 Katsufumi Uchiyama4 1Graduate School of Medical Science, Kitasato University, 2Department of Rehabilitation, Kitasato University School of Allied Health Sciences, 3Department of Orthopaedic Surgery, Kitasato East Hospital, 4Department of Orthopaedic Surgery, Kitasato University School of Medicine, Kanagawa, Japan Purpose: The objective of the study was to prospectively investigate the characteristics of gait among patients before and soon after curved periacetabular osteotomy (CPO) in comparison with healthy subjects. Subjects and methods: The subjects were six patients who underwent CPO and six healthy adults. Gait analysis was performed before surgery and at an average of 7.3 months after surgery using a three-dimensional motion analysis system. Temporospatial factors (gait velocity and stride length) and kinematic factors (range of motion of the hip joint in the sagittal plane, and ranges of tilting movement of the trunk and of the pelvic region in the coronal plane) were evaluated. Results: Gait velocity increased after surgery, but it was significantly lower than that of the healthy group (P<0.05). Stride length significantly increased after surgery compared to before surgery (P<0.05), though the significant difference seen before surgery disappeared. The full range of motion of the hip joint in the sagittal plane during walking increased after surgery, though the significant difference evident between the two groups before surgery also disappeared. The range of tilting movement of the trunk during walking increased after surgery, with a significant difference emerging when compared to the healthy group, which was not observed before surgery (P<0.05). Conclusion: The characteristics of gait were investigated in patients treated with CPO before and after surgery, and compared with those in healthy subjects. Gait improved, except for sway of the trunk while walking, despite the analysis being performed soon after surgery. Keywords: curved periacetabular osteotomy, gait analysis, range of motion of the hip joint, range of tilting movement of the trunk