Abstract
PurposeThe present study aimed to compare the capabilities of preoperative usual and maximal gait speeds in predicting functional recovery in patients who have undergone total hip arthroplasty (THA).MethodsPrimary and unilateral THAs were performed in 317 patients, and the proportion of patients who achieved unassisted walking (functional recovery) 5 days postoperatively was recorded as an outcome measure. Preoperative functional assessment included hip pain, leg muscle strength, range of motion (ROM), and gait speed evaluations. The capabilities of preoperative usual and maximal gait speeds in predicting functional recovery were compared based on the areas under the curves (AUCs) of receiver operating characteristic (ROC) curves. Further, ROC curves were constructed using two models: 1. a model of gait speed only and 2. a clinical model including age, sex, leg muscle strength, and ROM.ResultsOn the AUCs for predictive ability of functional recovery, maximal gait speed was greater than usual gait speed (0.66 and 0.70, respectively). The AUC for maximal gait speed was as large as that of the clinical model (0.70 and 0.70, respectively).ConclusionOur results suggest that maximal gait speed is a simple and useful prognostic indicator of functional recovery in patients who have undergone THA.
Highlights
Patients with end-stage osteoarthritis (OA) who undergo total hip arthroplasty (THA) demonstrate reduced pain and improved physical function and health-related quality of life [1]
After excluding 11 patients who were unable to walk before surgery and 8 patients with perioperative complications including postoperative cerebral infarction (n = 1), load limitation due to bone vulnerability (n = 2), fractures during surgery (n = 2), and those with deep venous thrombosis that needed treatment early after surgery (n = 3), 317 patients were included in this study
Even after adjusting for age, sex, muscle strength, and range of motion (ROM) (Model 2), the usual and maximal gait speeds were independently associated with functional recovery (HR = 2.32, 95% Confidence interval (CI) = 1.30–4.12; P = 0.004; Hazard ratio (HR) = 1.97, 95% CI = 1.30–2.97; P = 0.001, respectively)
Summary
Patients with end-stage osteoarthritis (OA) who undergo total hip arthroplasty (THA) demonstrate reduced pain and improved physical function and health-related quality of life [1]. Owing to rising healthcare-related costs and an increase in the demand for THA, it is necessary to develop a strategy for reducing the length of hospital stay and for the efficient and appropriate discharge of patients after treatment. Poor functional recovery during hospital stay is a common complication following major. Conventional factors, such as age, sex, body-mass index (BMI), range of motion (ROM), and muscle strength can only limitedly justify the variance in the postoperative functional recovery among patients [4, 5]; in contrast, performance-based measures may predict functional recovery better than conventional patient factors [6]. Due to Shibuya et al BMC Musculoskeletal Disorders (2020) 21:84 restrictions such as advancing ages of patients and limited spaces for evaluation, all of these evaluations are often difficult to perform
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