Purported advantages of total hip arthroplasty performed with minimally invasive surgical (MIS) approaches are less muscle damage and faster recovery. There are little data scientifically evaluating these claims. Twenty-four consecutive hips were randomized to total hip arthroplasty through 1 of 3 MIS approaches (2-incision, mini-posterior, and mini-anterolateral). Each patient underwent preoperative and postoperative gait analysis. Gait parameters included vertical ground reaction force, velocity, single-leg stance time, limb-loading rate, and abductor torque. All 3 groups demonstrated overall improvements in gait parameters at 6 weeks postoperatively. The anterolateral approach patients showed a decrease in the vertical ground reaction force at mid-stance, whereas the 2-incision and posterior approaches demonstrated no significant change. These results fail to demonstrate any significant advantage of the 2-incision approach over the posterior approach in kinetic gait parameters. Furthermore, the anterolateral approach demonstrates a gait pattern consistent with abductor muscle injury in the early recovery period, despite the MIS approach.

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