Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research & School of Health Sciences, University of South Australia, Adelaide, Australia.
The Medical Device Research Institute, School of Computer Science, Engineering and Mathematics, Flinders University, Adelaide, South Australia, Australia.
Osteoarthritis Cartilage. 2018 Jul;26(7):847-863. doi: 10.1016/j.joca.2018.02.897. Epub 2018 Feb 21.
To determine the change in walking gait biomechanics after total hip arthroplasty (THA) for osteoarthritis (OA) compared to the pre-operative gait status, and to compare the recovery of gait following THA with healthy individuals.
Systematic review with meta-analysis of studies investigating changes in gait biomechanics after THA compared to (1) preoperative levels and (2) healthy individuals. Data were pooled at commonly reported time points and standardised mean differences (SMDs) were calculated in meta-analyses for spatiotemporal, kinematic and kinetic parameters.
Seventy-four studies with a total of 2,477 patients were included. At 6 weeks postoperative, increases were evident for walking speed (SMD: 0.32, 95% confidence intervals (CI) 0.14, 0.50), stride length (SMD: 0.40, 95% CI 0.19, 0.61), step length (SMD: 0.41, 95% CI 0.23, 0.59), and transverse plane hip range of motion (ROM) (SMD: 0.36, 95% CI 0.05, 0.67) compared to pre-operative gait. Sagittal, coronal and transverse hip ROM was significantly increased at 3 months (SMDs: 0.50 to 1.07). At 12 months postoperative, patients demonstrated deficits compared with healthy individuals for walking speed (SMD: -0.59, 95% CI -1.08 to -0.11), stride length (SMD: -1.27, 95% CI -1.63, -0.91), single limb support time (SMD: -0.82, 95% CI -1.23, -0.41) and sagittal plane hip ROM (SMD: -1.16, 95% CI -1.83, -0.49). Risk of bias scores ranged from seven to 24 out of 26.
Following THA for OA, early improvements were demonstrated for spatiotemporal and kinematic gait patterns compared to the pre-operative levels. Deficits were still observed in THA patients compared to healthy individuals at 12 months.
比较全髋关节置换术（THA）治疗骨关节炎（OA）前后步行步态生物力学的变化，以及与健康个体相比 THA 后步态的恢复情况。
对比较 THA 后步态生物力学变化的研究进行系统评价和荟萃分析，比较（1）术前水平和（2）健康个体。在常报告的时间点汇总数据，并在荟萃分析中计算时空、运动学和动力学参数的标准化均数差（SMD）。
共纳入 74 项研究，共计 2477 例患者。术后 6 周，步行速度（SMD：0.32，95%置信区间[CI]：0.14，0.50）、步长（SMD：0.40，95%CI：0.19，0.61）、跨步长（SMD：0.41，95%CI：0.23，0.59）和横向平面髋关节活动范围（ROM）（SMD：0.36，95%CI：0.05，0.67）较术前步态增加。术后 3 个月时，矢状面、冠状面和横断面上髋关节 ROM 显著增加（SMD：0.50 至 1.07）。术后 12 个月，患者与健康个体相比，步行速度（SMD：-0.59，95%CI：-1.08 至-0.11）、步长（SMD：-1.27，95%CI：-1.63，-0.91）、单肢支撑时间（SMD：-0.82，95%CI：-1.23，-0.41）和矢状面髋关节 ROM（SMD：-1.16，95%CI：-1.83，-0.49）存在缺陷。偏倚风险评分范围为 26 分中的 7 分至 24 分。
与术前水平相比，OA 患者接受 THA 后，时空和运动学步态模式早期得到改善。但在 12 个月时，THA 患者与健康个体相比仍存在缺陷。
