Minimally invasive total hip arthroplasty is purported to allow an improved and faster rehabilitation in the immediate postoperative period because of reduced soft-tissue damage compared with total hip arthroplasty performed with use of a standard approach. In the present study, a minimally invasive approach was compared with a traditional standard approach in terms of the effect on gait kinematics as demonstrated with gait analysis and electromyography. Twenty randomized patients who underwent a primary total hip replacement with use of a minimally invasive modified Watson-Jones approach (minimally invasive group) were compared with a group of twenty patients who underwent a total hip arthroplasty with use of a standard transgluteal Hardinge approach (standard group). All patients received the same cementless implant, inserted with use of standard instruments, and all operations were performed by a single, experienced surgeon. The patients were evaluated with use of three-dimensional gait analysis and dynamic electromyograms at three time points: preoperatively, ten days postoperatively, and twelve weeks postoperatively. Temporospatial and joint-kinematic parameters were evaluated. There were no significant differences between the two groups with regard to the temporospatial variables of velocity, cadence, step length, and stride length at any tested time point. With regard to the range of motion of the operatively treated hip, the minimally invasive group had a smaller decrease at the ten-day time point in comparison with the standard group. However, this finding was not significant. The reduction in the range of motion was mainly caused by reduced hip extension. A compensatory increase in the pelvic tilt was observed in both groups. One patient in the standard group showed a positive Trendelenburg gait ten days postoperatively; it had disappeared completely at the twelve-week time point. With regard to gait kinematics in the early postoperative period (three months), the present study showed no significant benefit for patients who underwent a total hip arthroplasty through a minimally invasive Watson-Jones approach in comparison with those who were managed with a standard transgluteal approach.

Background: The aim of the study was to evaluate how clubfeet treated with the Ponseti method compare with control feet in gait analysis and whether additional information can be provided by the Oxford foot model. Methods: All patients with a minimum age of three years in our prospective database of clubfeet treated with the Ponseti method were considered for inclusion. Exclusion criteria were an associated syndrome or neurological disease, positional (slight) clubfoot, and presentation at an age of more than three months. Of the 125 patients with 199 clubfeet who satisfied the criteria, thirty-six (29%) agreed to participate in the study. Four of these were excluded because of insufficient gait analysis data, leaving thirty-two patients with fifty clubfeet for evaluation. Clinical examination and three-dimensional gait analysis including the Oxford foot model were performed, and a disease-specific questionnaire was administered. Kinetic and kinematic results were compared with those of an age-matched control group (n = 15). Results: The mean score on the disease-specific questionnaire was 83.5. Gait analysis showed significantly decreased range of motion, plantar flexion, and power of the ankle compared with controls. The mean external foot progression angle of 5.7° in the Ponseti group was slightly less than that in the controls. Slight intoeing occurred in 24%, and 12% did not achieve a neutral position during swing phase. Slight compensation was observed, including external rotation of the hip in 28%. The Oxford foot model revealed differences in foot motion between the groups. Conclusions: Clubfoot treatment with the Ponseti method yielded good clinical results with high functional scores. Three-dimensional gait analysis demonstrated distinctive but slight deviations. Intoeing was less frequent and less severe compared with groups in the literature. We recommend the use of three-dimensional gait analysis, including a foot model, as an objective tool for evaluation of the results of clubfoot treatment. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.