scholarly journals Sex-Specific Difference in Dynamic Balance Following Total Hip Replacement

2021 ◽  
Author(s):  
Robin M Queen ◽  
Daniel Schmitt
Keyword(s):  
Older Adults ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Repeated Measures ◽  
Dynamic Balance ◽  
Total Hip ◽  
Female Patients ◽  
Single Leg Stance ◽  
Balance Deficits ◽  
Operative Limb

Abstract Background and Objectives Total hip replacement (THA) is a common surgical procedure in older adults (65 years or older). THA has high patient satisfaction, but little is known about balance and mobility limitations after surgery and if outcomes are sex-specific. To evaluate post-THA asymmetry during unilateral standing and a dynamic balance and reach test and test the hypotheses that balance performance would be decreased on the surgical limb and that balance deficits would be greater in women than men. Research Design and Methods Primary, unilateral THA (70 male, 57 female) patients completed a bilateral 10-second single leg stance test. Sixty male but only 34 female participants could maintain unilateral balance for 10 seconds or greater. The cohort who successfully completed the 10-second single limb stance test then completed a Lower Quarter Y-Balance Test (YBT-LQ) in which the maximum anterior (ANT), posteromedial (PM) and posterolateral (PL) reach distances were obtained bilaterally and used to calculate the asymmetry score. All variables were compared using a mixed-model repeated-measures ANOVA (sex by limb), while independent samples t-tests were used to assess sex-specific asymmetry. Results Women failed single leg stance at a higher rate than men (85.7% vs. 59.6%; p=0.001). Reach distance was different between limbs for all reach directions (p<0.004) with greater reach distance on the non-operative limb for all patients. Men had a greater reach distance in the ANT (p=0.004), and PM (p=0.006) directions. Discussion and Implications These results indicate that post-THA the operative limb and female patients have greater balance limitations. These results are novel and reveal sex-specific patterns that emphasize the need for sex-specific post-operative rehabilitation programs to improve long-term outcomes, especially in older adults with muscle weakness and balance deficits.

scholarly journals Balance a few years after total hip replacement

2019 ◽  
Author(s):  
Agnieszka Wareńczak ◽  
Przemysław Lisiński
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Dynamic Balance ◽  
Berg Balance Scale ◽  
Step Test ◽  
Control Group ◽  
Timed Up And Go ◽  
Total Hip ◽  
Functional Reach ◽  
Functional Reach Test

Abstract Background: The aim of the study was to conduct a long-term evaluation of whether total hip replacement permanently affects the quality of postural reactions and body balance. Material and methods: The unilateral Total Hip Replacement (THR) group consisted of 30 subjects (mean age: 69.4). The control group consisted of 30 healthy subjects (mean age: 68.8). The force platform and functional tests such as Timed Up and Go, 3m walk test, Functional Reach Test, 30s Chair Stand Test, Step Test and Berg Balance Scale were used to assess dynamic balance. Results: Subjects from the study group exhibited significantly increased time (p=0.002) and distance (p=0.012) in the tests performed on the force platform compared to the control group. We also observed worse balance and functional test scores in the THR group: Timed Up and Go test (p<0.001), 3m walk test (p<0.001), Functional Reach Test (p=0.003), 30s Chair Stand Test (p=0.002) and Step Test (operated leg: p<0.001, non-operated leg: p=0.002). The results obtained in the Berg Balance Scale tests were not significantly different between the groups (p=0.597). Conclusions: Our research shows that total hip replacement permanently impairs patients’ dynamic balance and functionality in certain lower-extremity activities. Keywords: balance, total hip replacement, gait, muscle strength

The effects of the empowerment education program in older adults with total hip replacement surgery

2017 ◽  
Vol 73 (8) ◽  
pp. 1848-1861 ◽  
Author(s):  
Tzu-Ting Huang ◽  
Chia-Chun Sung ◽  
Woan-Shyuan Wang ◽  
Bi-Hwa Wang
Keyword(s):  
Older Adults ◽  
Total Hip Replacement ◽  
Education Program ◽  
Hip Replacement ◽  
Total Hip ◽  
Replacement Surgery ◽  
Hip Replacement Surgery

scholarly journals Predictors of total hip replacement in community based older adults: a cohort study

2020 ◽  
Author(s):  
Veronica Mezhov ◽  
Laura L Laslett ◽  
Harbeer Ahedi ◽  
C Leigh Blizzard ◽  
Richard M Aspden ◽  
...  
Keyword(s):  
Older Adults ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Community Dwelling ◽  
Hip Pain ◽  
Mineral Density ◽  
Mixed Effect ◽  
Total Hip ◽  
End Stage ◽  
Cam Morphology

Abstract Background: Hip osteoarthritis (OA) commonly affects older adults and leads to high morbidity. There is no preventative treatment available and total hip replacement (THR) is offered for end stage disease. Known predictors of THR include pain and radiographic OA. Hip structure has also been shown to worsen hip OA and predict THR. A better understanding of predictors of THR can aid in triaging patients and researching preventative strategies. The purpose of this study is to describe predictors of THR in community dwelling older adults. Methods: At baseline, participants had assessment of radiographic OA and cam morphology (from pelvic radiographs), shape mode scores (from dual energy X-ray absorptiometry (DXA)) and hip bone mineral density (BMD) (from DXA). After 2.6 and 5 years, participants reported hip pain using WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and had hip structural changes assessed using magnetic resonance imaging (MRI). Risk of THR was analysed using mixed-effect Poisson regression.Results: Incidence of THR for OA over 14 years was 5.0% (40 / 802). As expected, WOMAC hip pain and hip radiographic OA both predicted risk of THR. Additionally, shape mode 2 score (decreasing acetabular coverage) (RR 1.57 per SD; 95% CI 1.01-2.46), shape mode 4 score (non-spherical femoral head) (RR 0.65/SD; 95% CI 0.44-0.97), cam morphology (α >60°) (RR 2.66/SD; 95% CI 1.38-5.13), neck of femur BMD (RR 1.85/SD, 95% CI 1.4-2.44) and bone marrow lesions (BMLs) increased risk of THR (RR 5.62/unit; 95% CI 1.1 – 28.81). Conclusion: In addition to hip pain and radiographic hip OA, measures of hip shape, cam morphology, BMD and BMLs independently predict risk of THR. This supports the role of hip bone geometry and structure in the pathogenesis of end stage hip OA and has identified factors that can be used to improve prediction models for THR.

scholarly journals Predictors of total hip replacement in community based older adults: a cohort study

2019 ◽  
Author(s):  
Veronica Mezhov ◽  
Laura L Laslett ◽  
Harbeer Ahedi ◽  
C Leigh Blizzard ◽  
Richard M Aspden ◽  
...  
Keyword(s):  
Older Adults ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Community Dwelling ◽  
Hip Pain ◽  
Mineral Density ◽  
Mixed Effect ◽  
Total Hip ◽  
Cam Impingement ◽  
End Stage

Abstract Background Hip osteoarthritis (OA) commonly affects older adults and leads to high morbidity. There is no preventative treatment available and total hip replacement (THR) is offered for end stage disease. Known predictors of THR include pain and radiographic OA. Hip structure has also been shown to worsen hip OA and predict THR. A better understanding of predictors of THR can aid in triaging patients and researching preventative strategies. The purpose of this study is to describe predictors of THR in community dwelling older adults.Methods At baseline, participants had assessment of radiographicOA and cam impingement (from pelvic radiographs), shape mode scores (from dual energy X-ray absorptiometry (DXA)) and hip bone mineral density (BMD) (from DXA). After 2.6 and 5 years, participants reported hip pain using WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and had hip structural changes assessed using magnetic resonance imaging (MRI). Risk of THR was analysed using mixed-effect Poisson regression.Results Incidence of THR for OA over 14 years was 5.0% (40 / 802). As expected, WOMAC hip pain and hip radiographic OA both predicted risk of THR. Additionally, shape mode 2 score (decreasing acetabular coverage) (RR 1.57 per SD; 95% CI 1.01-2.46), shape mode 4 score (non-spherical femoral head) (RR 0.65/SD; 95% CI 0.44-0.97), cam impingement (α >60°) (RR 2.66/SD; 95% CI 1.38-5.13), neck of femur BMD (RR 1.85/SD, 95% CI 1.4-2.44) and bone marrow lesions (BMLs) increased risk of THR (RR 5.62/unit; 95% CI 1.1 – 28.81). There was a trend for hip effusions to increase the risk of THR (RR 1.88/SD; 95% CI 0.24 to 14.78).Conclusion In addition to hip pain and radiographic hip OA, measures of hip shape, cam impingement, BMD and BMLs independently predict risk of THR. This supports the role of hip bone geometry and structure in the pathogenesis of end stage hip OA and has identified factors that can be used to improve prediction models for THR.

scholarly journals Predictors of total hip replacement in community based older adults: a cohort study

2021 ◽  
Author(s):  
Veronica Mezhov ◽  
Laura L. Laslett ◽  
Harbeer Ahedi ◽  
C Leigh Blizzard ◽  
Richard M. Aspden ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Community Based ◽  
Total Hip

scholarly journals Predictors of total hip replacement in community based older adults: a cohort study

2019 ◽  
Vol 27 ◽  
pp. S79-S80 ◽  
Author(s):  
V. Mezhov ◽  
L.L. Laslett ◽  
H. Ahedi ◽  
C.L. Blizzard ◽  
R.M. Aspden ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Community Based ◽  
Total Hip

Incidence and Associated Risk Factors for Falls in Older Adults Postdischarge Who Undergo Elective Total Hip Replacement Surgery—A Prospective Cohort Study

2020 ◽  
Author(s):  
Anne-Marie Hill ◽  
Gail Ross-Adjie ◽  
Steven M McPhail ◽  
Angela Jacques ◽  
Max Bulsara ◽  
...  
Keyword(s):  
Older Adults ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Odds Ratio ◽  
Total Hip ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Falls In Older Adults ◽  
Associated Risk Factors ◽  
Risk Factors For Falls

Abstract Background Hip replacement surgery improves health-related quality of life; however, it has been suggested that falls rates increase after hospital discharge. The aim of the study was to determine the incidence and associated risk factors for falls in older adults in the 12 months after undergoing elective total hip replacement surgery. Methods A prospective observational cohort study was conducted. Participants were adults aged 60 years or older who underwent primary elective total hip replacement surgery in a private tertiary hospital in Perth, Australia. Baseline data collected immediately prior to discharge included use of walking aids, medications, and functional level of independence (using Katz and Lawton scales). Falls data were collected for 12 months using calendars and monthly phone calls. Data were analyzed using logistic and negative binomial regression modeling. Results Participants’ ([n = 167], 54.4% female) mean age was 71.2 (±6.9) years. There were 51 (31%) participants who used a walking aid prior to surgery. There were 140 falls reported over 12 months by 67 (42%) participants, of which 90 (64.3%) were injurious (n = 9 fractures). The fall rate was 2.6 per 1000 patient-days. Age (adjusted odds ratio 1.10, 95% confidence interval 1.01–1.20) and hospital length of stay (adjusted odds ratio 1.24, 95% confidence interval 1.00–1.54).were significantly associated with sustaining multiple falls. Conclusions More than 40% of older adults fell in the 12 months after elective hip replacement surgery although the cohort had low fall risk prior to surgery. Rehabilitation after hip replacement surgery should consider fall prevention.

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