Antalgic Gait
The medical term for the gait pattern seen in patients with severe hip osteoarthritis who need hip replacement is "antalgic gait." 1
Defining Characteristics
An antalgic gait is a pain-avoidance walking pattern with these specific features:
- Shortened stance phase on the affected limb to minimize time bearing weight on the painful hip 1
- Limited hip extension before toe-off in the late stance phase, which is the most characteristic finding in hip osteoarthritis 2
- Asymmetric step length between the affected and unaffected sides 3
- Asymmetric weight-bearing with reduced maximum pressure on the affected limb 3
Biomechanical Compensation Patterns
Approximately one-third of patients develop a compensatory mechanism that paradoxically worsens their condition:
- Increased hip flexion at heel strike to compensate for the lack of hip extension 2
- This compensation increases load on the affected side, potentially accelerating osteoarthritis progression 2
- Excessive anterior pelvic tilt persists even after conservative treatment 4
Clinical Significance
The antalgic gait pattern has important implications:
- Pedobarography can objectively measure the asymmetry in weight-bearing and step length, making it a clinically suitable diagnostic tool 3
- Gait abnormalities persist in many patients despite properly conducted total hip arthroplasty, particularly limitations in hip extension and rotation 5
- The Gait Deviation Index (GDI) improves by an average of 4.4 points six months after surgery, indicating overall improvement in gait pathology 6
- Patients with the most pathological preoperative gait patterns show the greatest improvement after surgery 6
Common Pitfall
Do not assume that clinical improvement in pain and passive range of motion automatically translates to normalized gait patterns. Dynamic gait abnormalities frequently persist despite significant improvements in clinical scoring systems, particularly deficits in hip extensor power and terminal stance hip extension 4.