Functional recovery after hip resurfacing and rehabilitation

Context: Surface replacement of the hip is aimed especially at active patients, and it seems to achieve optimal functional results in a short time if associated with a tailored rehabilitation protocol. Objective: To assess the functional outcome in a group of active patients after hip resurfacing. Design: Clinical measurement and controlled laboratory study in a case series. Setting: Gait-analysis laboratory. Participants: 8 patients and a control group of 10 subjects. Interventions: Patients treated with Birmingham hip-resurfacing system and a tailored rehabilitation protocol Main Outcome Measures: Clinical assessment (Harris Hip Score [HHS]) and instrumented gait analysis including muscular electromyographic assessment. Patients were assessed preoperatively and at 3 and 9 mo follow-up after surgery. Results: HHS showed a significant increase from the baseline to 3- (P =.008) and 9-month (P =.014) follow-up; 5 patients returned to sport. Gait pattern in the presented case series of patients improved substantially 3 mo postoperatively, and minimal further changes were present 9 months postoperatively. Residual abnormalities of time-distance and hip-kinematics parameters were consistent with a slow gait. A complete restoration of the muscle-activation pattern during gait was achieved. Conclusion: Hip resurfacing associated with a rehabilitation protocol based on the characteristics of the implant provides excellent clinical and functional outcome, especially for very active patients.