Predictors of physical functioning after total hip arthroplasty: a systematic review

Abstract

ObjectiveThe objective of this systematic review of the literature was to identify the predictors of functional outcome after total hip arthroplasty (THA).MethodA systematic literature search in Web of Science, CINAHL, EMBASE and PubMed was conducted on 23 June 2015. The articles were selected based on their quality, relevance and measurement of the predictive factor. The level of evidence of all studies was determined using the GRADE rating scheme.ResultsThe initial search resulted in 1092 citations. After application of the inclusion and exclusion criteria, 33 articles met our eligibility criteria and were graded. Included studies were classified as level of evidence low (11), moderate (17) or high (5). Of the included studies, 18 evaluated body mass index (BMI), 17 evaluated preoperative physical functions, 15 evaluated age, 15 evaluated gender and 13 evaluated comorbidity. There was strong evidence suggesting an association between BMI, age, comorbidity, preoperative physical functions and mental health with functional outcome after THA. There was weak evidence suggesting an association between quadriceps strength and education with functional outcome after THA. The evidence was inconsistent for associations with gender and socioeconomic status and functional outcome following THA. We found limited evidence suggesting that alcohol consumption, vitamin D insufficiency and allergies were predictors of functional outcome following THA.ConclusionsWe have identified multiple predictors of functional outcome after THA, which will enable general practitioners and orthopaedic surgeons to better predict the improvement in physical functioning for their patients with THA. They can use this information to provide patient-specific advice regarding the referral for THA and the expected outcomes after THA. Further research with consistent measurement tools, outcomes and duration of follow-up across studies is needed to confirm the influence of these factors.

The Influence of Obesity on Hip Pain, Function, and Satisfaction 10 Years Following Total Hip Arthroplasty

“…These studies present little evidence to suggest obese patients experience a poor outcome following THA, in fact nearly all demonstrate they have much to gain. In 2 recent systematic reviews [40,41], the number of studies with findings favoring nonobese patients outnumbered those finding no difference in their function. Many studies were limited by small numbers and did not consider the degree of improvement from the patients' baseline function, which tends to be lower in obese cohorts.…”

Strengthening Quadriceps Muscles with Neuromuscular Electrical Stimulation Following Total Hip Replacement: a Review

“…Lower extremity muscle mass has been reported as a key determinant of physical performance amongst mobility-limited older adults, and total leg mass and muscle strength are considered strong independent predictors of the level of functional impairment [10,11]. More specifically, there is evidence to suggest an association between quadriceps femoris strength and functional outcomes [12], as quadriceps muscle strength is functionally relevant for performance of daily tasks [13,14]. Both knee extensor concentric and eccentric strength and power are associated with improved performance of the sit-to-stand movement [15] and muscle activity that produces sufficient force is essential to enable a patient to walk, rise from a chair or climb stairs [16].…”

Association Between Preoperative Vitamin D Status and Short-Term Physical Performance after Total Hip Arthroplasty: A Prospective Study

“…THA has a high success rate and provides pain relief, improvement of physical functioning, and better health-related quality of life [3][4][5]. Postoperative recovery of THA is mainly determined by muscle function around the hip [4].…”