Relationship Between Self-Reported Function, Functional Tests and Biomechanical Parameters in Patients 12 Months After Total Hip Arthroplasty: A Preliminary Cross-Sectional Study

Abstract

Background/Purpose Several methods are used to evaluate the outcome of total hip arthroplasty (THA), however, their relationship at different time points after surgery is unclear. The purpose of this exploratory study was to investigate correlations between self-report function, performance-based tests (PBTs) and biomechanical parameters in patients 12 months after THA. Methods Eleven patients were included in this preliminary cross-sectional study. Hip disability and Osteoarthritis Outcome Score (HOOS) was completed for self-reported function. As PBTs, the Timed-up-and-Go test (TUG) and 30-Second-Chair-Stand test (30CST) were used. Biomechanical parameters were derived from analyses of hip strength, gait and balance. Potential correlations were calculated using Spearman correlation coefficient r. Results HOOS scores and parameters of PBTs showed moderate to strong correlations (0.3 < r < 0.7). Correlation analysis between HOOS scores and biomechanical parameters revealed moderate to strong correlations for hip strength whereas correlations with gait parameters and balance were rather weak (r < 0.3). Moderate to strong correlations were also found between parameters of hip strength and 30CST. Conclusion For THA outcome assessment 12 months after surgery, our first results indicate that self-report measures or PBTs could be used. Analysis of hip strength also appears to be reflected in HOOS and PBT parameters and may be considered as an adjunct. Given the weak correlations with gait and balance parameters, we suggest that gait analysis and balance testing should be performed in addition to PROMs and PBTs as they may provide supplementary information, especially for THA patients that are at risk for falls.

Post-Arthroplasty Spatiotemporal Gait Parameters in Patients with Hip Osteoarthritis or Developmental Dysplasia of the Hip: An Observational Study

“…On the other hand, a lower level of hip pain interference in usual work/housework (item 12) was linked to a slower cadence. Our findings support previous studies in which self-reported outcomes and biomechanical parameters were correlated in post-THA patients 12 months post-THA [ 21 , 22 ]. In the study of John et al [ 21 ], the Hip Disability and Osteoarthritis Outcome Score (HOOS) correlated strongly with hip strength, while the correlations with step length asymmetry and contact time asymmetry were not significant and relatively weak (r < 0.32).…”

“…Secondary outcomes included potential correlations between postoperative spatiotemporal and demographic/clinical characteristics relating to patients’ functionality. Based on previous relevant studies on post-THA patients [ 21 , 22 ], we hypothesized that postoperative spatiotemporal characteristics have the same trend with patient-reported outcomes. Biomechanists and rehabilitation experts could utilize such evidence to advance the development of targeted rehabilitation programs that ultimately improve the functional capacity of patients.…”

Post-Arthroplasty Spatiotemporal Gait Parameters in Patients with Hip Osteoarthritis or Developmental Dysplasia of the Hip: An Observational Study

“…On the other hand, a lower level of hip pain interference in usual work/housework (item 12) was linked to a slower cadence. Our findings support previous studies in which self-reported outcomes and biomechanical parameters were correlated in post-THA patients 12 months post-THA [38,39]. In the study of John et al [38], the Hip Disability and Osteoarthritis Outcome Score (HOOS) correlated strongly with hip strength, while the correlations with step length asymmetry and contact time asymmetry were not significant and relatively weak (r < 0.32).…”

“…Our findings support previous studies in which self-reported outcomes and biomechanical parameters were correlated in post-THA patients 12 months post-THA [38,39]. In the study of John et al [38], the Hip Disability and Osteoarthritis Outcome Score (HOOS) correlated strongly with hip strength, while the correlations with step length asymmetry and contact time asymmetry were not significant and relatively weak (r < 0.32). In the study of Bolink et al [39], moderate to strong significant correlations were found between the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and walking speed, cadence, and step time (0.31 > r <0.51).…”

“…Postoperative gait analysis is generally accepted as an objective measurement of surgical success since it effectively quantifies SGPs [20]. In addition to the objective gait assessment, the use of selfreported outcomes like OHS can provide unique information on the impact of treatment from the patient's perspective [37], and it is complementary to the overall assessment of patients' recovery; this is essential in clinical research and practice involving THA patients [38]. In our study, although the OA group had marginally greater speed (p=0.054) and faster cadence (p=0.057) compared to DDH group, they reported significant satisfactory joint function as expressed by OHS total score (p=0.02).…”