How do patients walk following hip replacement? Researchers at Hospital for Special Surgery (HSS) aim to find out…with the help of a portable gait analysis. The study, which will assess the early outcomes of several different hip replacement techniques, will evaluate pain and function before surgery and six weeks after surgery.
HSS Testing Portable Gait Analysis Mat
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According to the July 7, 2016 news release, four different surgical techniques will be assessed: (1) standard hip replacement (posterior approach with small incisions); (2) direct anterior hip replacement; (3) robotic-assisted posterior; and (4) robotic-assisted anterior.
“There are various surgical approaches for a physician to consider when performing hip replacement, and among those, the direct anterior and traditional posterior have been compared extensively to determine if one approach may be superior to the other. But there is currently no literature that explores the outcomes of robotic-assisted hip replacement compared to the anterior and posterior approaches, ” said Michael Alexiades, M.D., an orthopedic surgeon at Hospital for Special Surgery and principal investigator. “To the best of our knowledge, this study will be the first to compare all four approaches in one study.”
“Patients’ walking patterns are very important. If they are not walking symmetrically or have abnormal patterns because of weakness or another issue, they may be compensating by putting pressure on their spine or other joints, ” said Rupali Joshi, PT, Ph.D., study co-investigator. “In addition to objectively analyzing functional outcomes after hip replacement, the system will allow us to tailor a physical therapy program or provide specific exercises to help patients overcome weaknesses and develop a normal walking pattern.”
As indicated in the news release, “The mobile gait analysis system consists of an electronic walkway—the mat—that contains thousands of sensors to analyze various aspects of the way a person walks. It is connected to a laptop computer with special software that measures cadence, speed, step length and other gait parameters. Data and images of the gait pattern are processed, recorded and stored in the computer. The walking test takes less than five minutes.”
Dr. Joshi told OTW, “The testing is going well. Participants are more agreeable to participate when they know it will only take less than five minutes in total from filling out forms to walking on the mat.”
“Patients are also very surprised to know there is a test that measures their walking pattern and are curious to see the objective difference in their walking pattern after surgery.”
The gait analysis mat was developed by CIR Systems, Inc.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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