How closely do surgeons follow gait analysis recommendations and why?

Gait laboratory recommendations for surgery were compared with actual surgeries performed in 30 consecutive patients. The agreement between the procedures performed and those recommended by the gait laboratory averaged 93.2+/-13.4% overall and 86.0+/-18.3% excluding patients referred by the gait laboratory physician. For 23 patients (77%), the recommended surgeries exactly matched the surgeries ultimately performed. In the other patients, seven procedures that had not been recommended were performed, and seven procedures that had been recommended were not performed. Explanations for the differences included preoperative clinical or radiographic evaluation, intraoperative assessment, changes in function between gait analysis and surgery, and patient/family request.