Mobility of patients with coxarthrosis

Abstract

The common methods of evaluating walking capacity of patients with osteoarthritis of the hip reported in literature are all inaccurate and are based on symptoms. It has been proved, that these informations are to uncertain and therefore have to be replaced by objective criterias. A method of assessment was developed which can easily be applied in clinical routine without great apparative means. With a pedometer and a stopwatch the time can be measured which the patient needs to pass a distance of 30 meters as quick as possible (MAX 30). Similarly the maximal walking distance (MAX DIST) is evaluated as well as the average walking distance (MEDIAN). It could be shown, that walking capacity is not dependent on the amount of degenerative changes, duration of hip disease and hip motion. Walking capacity is negatively influenced by pain, muscle atrophy and lack of training. Patients with osteoarthritis of the hip are able to walk on average 3 km without interruption, thereby they develop a speed of 4 km/h on average. So they are not much slower than healthy subjects. The two must important aims of conservative treatment of hip disease must be alleviation of pain and improvement of muscular strength. Main indication criterium for hip replacement is walking capacity, not the radiological assessed amount of degenerative changes.