Does total hip replacement impact on postural stability?

Abstract

Background Total hip replacement (THR) is a procedure which can improve the quality of life in patients with osteoarthritis. However, deficits in static stability and impairment of lower limb efficiency can be observed even several months after the procedure. The aim of this study was to investigate the static balance of the standing position in patients treated by THR. Methods The study included 30 THR patients and 30 healthy subjects. The subjects were examined once. A Metitur balance platform and a one-leg standing (OLS) test were used to assess the static balance. The tests on the balance platform were performed in several positions with different foot placement, such as normal standing, eyes open (NS EO) and eyes closed (NS EC) positions, tandem position (TP), the second form of tandem position (2TP) and one-leg standing position (1 L). Results Significant imbalance in the sagittal plane during normal standing EO and EC positions were found in the THR group. No significant differences in the measured parameters were found during tests in tandem, the second form of tandem and one-leg standing positions in the groups. The mean time of standing on the operated limb in the THR group during the OLS test was significantly shorter than that in the control group. Conclusions Deficits in static balance may occur in THR patients even a long time after the procedure. The test performed in the NS position is sufficient to assess the balance. The rehabilitation protocols currently used after THR should include postural stability exercises. Trial registration number Trial registry: NCT03218267 . 12 July 2017 (retrospectively registered).

Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review

“…Static balance/postural stability was assessed in 20 studies [ 11 , 35 , 37 – 53 , 63 ]; dynamic balance was assessed in 10 studies [ 34 , 36 , 41 , 52 , 54 – 59 ]; proprioception in terms of sense of joint position was assessed in 2 studies [ 60 , 61 ]; clinical scales and other test batteries for balance assessment were used in 10 studies [ 11 , 13 , 40 , 41 , 52 , 59 , 60 , 62 – 64 ].…”

Spinopelvic Alignment and Its Use in Total Hip Replacement Preoperative Planning—Decision Making Guide and Literature Review

“…There is one exception in which the order should be reversed. The spinal fusion may be done earlier than THR when the patient's pelvic retroversion is increased [1,2]. Another approach may cause risk to THR stability [38].…”

“…Medical procedures performed on patients should also be taken into account. It was demonstrated that spinal fusion before THR might increase the risk of dislocation and impingement by increasing posterior pelvic tilt [1]. Nevertheless, the more segments are involved, the higher the limitations and the more dysfunctional the hip-spine biomechanics are [1,2].…”

“…These factors lead to poor quality of life-insomnia, depression, lack of confidence, and limitations in daily activities, work, or hobbies. OA causes very serious problems for patients and significant social and economic costs [1].…”

Parameters of podobarography after hip total endoprosthetics at different surgical accesses

“…Foot transfer duration in patients after surgery on the side of the intervention is significantly greater than on the non-operated foot. The legs uneven loading in patients underwent hip replacement when walking is associated with a deficiency of sensory mechanism around the artificial joint, which in turn leads to overloading of the non-operated leg [8,9]. Among these reasons of the main symptoms persistance, our task was to investigate the role and degree of impact of various surgical approaches of hip replacement in early and long-term follow-up, which remains the subject of debate and is still unexplained.…”