Prótesis total de cadera. Cambios funcionales al alta hospitalaria de rehabilitación

Abstract

in patients with total hip prosthesis between the period of the surgery and the hospital discharge from Rehabilitation, as well as to search for the variables related with the functional level. Patients and method: Prospective study of 50 consecutive cases. The variables gathered were: age, gender, diagnosis, alterations associated with the locomotor apparatus, pain visual analogue scale, articular balance, muscular balance, hospital stay, Barthel index and measurement of motor functional independence. The mean age of the patients was 66.6 (SD 11.8) years. The most frequent diagnoses were: coxarthrosis 29 (58%); replacement due to aseptic mobilization 10 (20%) and ischemic necrosis 8 (16%). The statistical tests used were the: Chi squared, Student’s T test, Mann-Whitney U Test, Kruskall-Wallis and Spearman correlation. For all the contrasts, a significance level of p ≤ 0.05 is accepted. Results: The days of hospitalization in Rehabilitation were 11.1 (SD 4.0). The pain visual analogue scale went from a previous 61.7 (SD 22.5) to 15.8 (SD 18.8) on discharge (p < 0.001, CI 95% 36.8-53.7). The articular balance (flexion and abduction) increased 5.6° (SD 14.3) (p = 0.008, CI 95% 1.5-9.7) and 8° (SD 12.0) (p < 0.001, CI 95% 4.5-11.4), respectively. Efficiency (increase between the measurement of motor functional independence/days of rehabilitation hospitalization) was 1.6 (SD 0.9) points/day. A relationship was found between the measurement of previous motor functional independence and: age (p < 0.002, Spearman’s rho -0.416), gender (p = 0.048), alterations associated with the locomotor apparatus (p = 0.044) and articular flexion balance prior to surgery (p = 0.009, Spearman’s rho 0.367). Conclusions: In our sample, after the total hip prosthesis, the pain and articular function improved significantly. The functional level that was obtained on rehabilitation discharge can be superimposed to that prior to the surgery. The previous functional level is related with age, gender, flexion of the hip and alterations associated with the locomotor apparatus.