Gait analysis and WOMAC are complementary in assessing functional outcome in total hip replacement

Abstract

Objective: To investigate the correlation between objective and subjective evaluation of patients with total hip replacement. Design: Prospective preliminary trial comparing the Western Ontario and McMaster University questionnaire (WOMAC) and gait analysis preoperatively and three months postoperatively. Setting: A German academic orthopaedic centre specializing in total hip replacement surgery. Subjects: Seventeen patients (median age 70 years) with hip osteoarthritis. Intervention: All patients had had a primary unilateral total hip replacement. Main measures: WOMAC questionnaire to assess self-perceived health status and gait analysis to determine objective gait parameters. Results: Performance of walking as well as subjective judgement of health status improved following surgery (gait speed P = 0.0222; stride length P = 0.038; stance phase ratio P = 0.0466; WOMAC P < 0.0001). However, the correlation between gait parameters and WOMAC was poor ( r = -0.27 or less). Correlation between changes of walking parameters and WOMAC was bad to good ( r = 0.01 to r = -0.72). Conclusion: The WOMAC questionnaire might not reflect walking performance. The addition of gait analysis is recommended to gain objective information about the quality of gait.

Short-term Recovery of Balance Control after Total Hip Arthroplasty

“…Consistent with the literature, by 16 weeks postsurgery, patients undergoing THA had an increase in gait velocity and stride length compared with before surgery (Table 4) [3,5,23,24,30,38,43,47]. We observed no major differences between patients and control subjects at 16 weeks postsurgery for these variables, suggesting improved range of motion and/or hip muscle strength after surgery and more efficient leg progression during gait [32].…”

“…Although there have been reports of changes before and after surgery in gait velocity and stride length [23,47], changes in step width have not been reported. By maintaining a larger step width presurgery when compared with control subjects, patients showed strategy to accommodate a greater medial CoM-CoP inclination angle during gait.…”

“…Studies on postural balance during standing after THA showed patients had a greater medial-lateral sway [35] and reduced ability to control center of mass (CoM) movement [32] when compared with control subjects. Although walking velocity, stride length, and stride time reportedly are improved after THA [23,47], on average, patients continue to have a slower gait speed Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.…”

“…THA effectively decreases pain and improves mobility and quality of life [9,23]. Studies on postural balance during standing after THA showed patients had a greater medial-lateral sway [35] and reduced ability to control center of mass (CoM) movement [32] when compared with control subjects.…”

No Difference in Gait Recovery After THA With Different Head Diameters: A Prospective Randomized Study

“…One is the short followup period. However, the major part of gait recovery is known to occur within the early period [9,16], and our aim was to evaluate the early recovery of gait after THA with different head diameters. The second limitation is the relatively small number of patients evaluated in each group, which could reduce our statistical power and our ability to identify a difference if indeed one were to have been present.…”