Total hip replacement (THR) is one of the most common elective orthopaedic operations. However, evidence suggests that despite postoperative pain improvements, aspects of longer-term physical performance, such as walking ability, do not reach the levels expected when compared to the general population. Walking is best assessed by using gait analysis. This review aims to explain the concept of gait analysis, its use to evaluate THR outcomes, and its proposed future importance when evaluating new technologies proposed to improve functional recovery in individuals undergoing THR surgery. Furthermore, this review discusses the advantages and challenges of gait analysis in THR patients and provides recommendations for future work.

The Cycling against Hip Pain (CHAIN) programme is a six-week cycling and education treatment pathway for people with hip osteoarthritis. Preliminary results demonstrated significant improvements in clinical and patient-reported outcome measures following the course. Whilst the benefits of exercise for osteoarthritis are often reported in the short term, less is known about the long-term effects for this patient group. This study explores whether participants continued to self-manage their hip osteoarthritis five years after completing the course. A cross-sectional survey was conducted to collect data from participants who completed the CHAIN programme between October 2013 and February 2015 (n = 96). Questionnaires were sent by post in April 2019, and then non-responders were followed up again four weeks later. Eighty-three (87%) participants responded to the survey. Five years (range 4–6) after completion of a six-week cycling and education programme, 37 (45%) participants had not returned to their general practitioner for further treatment of their hip pain, and 47 (57%) had not pursued surgical intervention. All participants were still engaged in at least one physical activity per week and many reported that they had purchased a bike (29%), joined a gym (30%) or cycled regularly (indoor cycling 25%, outdoor cycling 24%). Eighty (96%) participants reported an increase in knowledge of self-managing their symptoms. The findings from this study suggest that many patients are motivated to self-manage their hip osteoarthritis, five years following a six-week cycling and education treatment pathway that encourages lifestyle change.

Background: Ceramic may be an alternative bearing surface that could be used to deal with the negative sequalae associated with the use of metal-on-metal (MoM) hip resurfacing implants, keeping the benefits of hip resurfacing without the risks. The aim of this study is to evaluate the additional financial and logistical implications that MoM hip resurfacing has, in comparison to its ceramic-on-ceramic (CoC) counterpart. Methods: Two different follow up protocols were analysed, according to current practice guidance, on how to follow up with hip resurfacing procedures. Reference costs were identified using the latest national cost collection data and data from the local biochemistry department. The results incorporated the number of hip resurfacings performed nationally. Results: The non-MoM protocol yielded a per operation lifetime follow up cost of £802.50, whereas the MoM protocol yielded a cost of £2132.83 at 25 years. Nationally, according to the 2023 data, this amounted to £561,750 versus £1,492,981 per year, respectively. MoM hip resurfacing is 2.6 times more expensive to be followed up with when compared to the standard protocol. Conclusion: The cost of the follow up of MoM bearings far exceeds that of non-MoM bearings. If CoC hip resurfacing is as clinically effective as MoM hip resurfacing, then the economics favour CoC bearing for resurfacing.