Total hip arthroplasty in the elderly: impact on functional performance

Abstract

Objectives: To compare gait and functional performance parameters in elderly subjects who had or had not total hip arthroplasty (THA). Methods: Our sample comprised 23 elderly subjects (72±6.5 years of age) with a mean of 2.6±1.3 years following THA, named the arthroplasty group (AG) and 23 asymptomatic elderly subjects (70.1±5.9 years of age), named the control group (CG). Case and control subjects were paired by gender, age, body mass index and level of physical activity. The GAITRite ® system was used to analyze various gait parameters in four situations: usual speed (US), fast speed (FS), slow speed (SS) and dual task (DT); the Dynamic Gait Index (DGI) and Timed Up and Go test (TUG) methods were used to evaluate functional capacity. The statistical analyses were carried out using the Shapiro-Wilk test, Student's-t-tests for independent samples, chi-square tests, ANOVA for repeated measurements and paired Student's-t-tests. Results: The AG had the worst results for gait speed (AG=1.18±0.13 and CG=1.39±0.09; p=0.012), symmetry index (SI) of step length (AG=3.60±1.01 and CG=1.12±0.59; p=0.000), SI of step time (AG=-2.65±0.92 and CG=0.99±0.74; p=0.000), SI of stance phase (AG=-2.55 and CG=-1.04±0.50; p=0.005), SI of single support phase (AG=-2.17±0.78 and CG=1.21±0.51; p=0.003), DGI (AG=20.04±1.91 and CG=21.69±1.45; p=0.001) and TUG (AG=14.67±1.94 and CG=10.08±1.49; p=0.001). Conclusion: Elderly subjects with a history of THA had changes in gait parameters and lower performance in TUG test even 2.6±1,3 years after surgery, which suggests functional impairment.

Decline in Gait Performance Detected by an Electronic Walkway System in 907 Older Adults of the Population-Based KORA-Age Study

“…We found that women with hip endoprostheses had a significantly reduced physical performance during fast walking as indicated by the gait parameters velocity and step length. These findings are somewhat different from a case-control study by Guedes et al [21], in which 23 subjects with hip arthroplasties differed significantly from their 23 controls in velocity on all walking tasks (usual, fast, slow and dual-task), but not in cadence. However, these data might be difficult to compare as the study by Guedes et al was based on a convenience sample and did not analyze sex-specific differences.…”

“…Previous studies assessing gait variables with an electronic walkway mat often did not take account of the impact of endoprostheses although gait patterns have been described to be significantly affected in those patients [11,12,13], and only very few studies have used the GAITRite system to describe gait patterns among persons with knee or hip endoprostheses [21,22]. We found that women with hip endoprostheses had a significantly reduced physical performance during fast walking as indicated by the gait parameters velocity and step length.…”

Total Joint Replacement in the Past Does Not Relate to a Deteriorated Functional Level and Health Status in the Oldest Old

“…It is also related to functional activities, such as crossing the street [19]. A recently published study confirmed our results of lower gait speed in subjects with a total joint replacement [19].…”

“…Gait speed is considered to be an important predictor of functional status and adverse health events [18, 19]. It is also related to functional activities, such as crossing the street [19].…”

Does preoperative body weight affect early postoperative functional activities in patients with total hip arthroplasty?

“…Total kalça artroplastisini takiben ameliyat sonrası dönemde yürüme parametrelerinde iyileşme sağlansa da kontrol grubuna kıyasla yürüme parametrelerindeki sapma veya bozuklukların devam ettiği çalışmalarda bildirilmektedir. [13,14] Bunlar içerisinde yürüme hızı, en sık ve kolay değerlendirilen yürüme parametrelerinden biri olup fonksiyonel hareketlerin devamı, günlük yaşam aktivitelerindeki bağımsızlık, düşme riski ve aktivite korkusu ile iliş-kili olması açısından da önemlidir. [13] Obez ve yaşlı bireylerde fonksiyonel kapasitelerindeki gerilemelere bağlı olarak yürüme hızı ve sallanma fazında obez olmayanlara kıyasla azalma meydana gelmektedir.…”