Höll Steffen, Blum Andreas, Gosheger Georg, Dieckmann Ralf, Winter Corinna, Rosenbaum Dieter
Department of Orthopedics and Tumor Orthopedics, University Hospital Muenster, Albert-Schweitzer-Str. 33, 48149, Münster, Germany.
Movement Analysis Laboratory, Institute of Experimental Musculoskeletal Medicine IEMM, University Hospital Münster, Domagkstrasse 3, 48149, Münster, Germany.
J Orthop Surg Res. 2018 Jun 15;13(1):148. doi: 10.1186/s13018-018-0775-4.
Subjective data and physical examinations of patients after total hip arthroplasty are used to assess the outcome. But regarding the physical activity, no objective data can be delivered by existing scores. The level of activity can be measured objectively by counting gait cycles. The aim of this study was to measure activity levels of patients before and after total hip arthroplasty (THA).
Forty-six patients were included in this prospective study. Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris Hip Score (HHS), and physical activity level based on the number of steps per day were assessed 1 week before surgery, 6 weeks postoperatively, and 3 months postoperatively. To assess the general constitution of the patients, the American Society of Anesthesiologists (ASA) score and BMI were determined. The physical activity level was measured by StepWatch 3™ Activity Monitor (SAM; Orthocare Innovations, Seattle, WA, USA). The number of GCs per day was assessed. Spearman's rank correlation coefficients were used to identify an association between age, body mass index (BMI), and American Society of Anesthesiologists classification with the number of gait cycles and to detect correlation between GCs and HHS and GCs and WOMAC.
From preoperatively to 6 weeks postoperatively, the number of gait cycles did not alter significantly. Three months postoperatively, the number of GC/d and GC/h improved significantly. HHS and WOMAC improved significantly from before surgery to 6 weeks and to 3 months follow-up. The number of gait cycles per day did not correlate with the HHS and the WOMAC score at any point of measurement. Age, BMI, and ASA classification did not influence the results.
By using a StepWatch 3™ Activity Monitor objective data about physical activity before and after THA can be measured reliable. Subjective and objective data in the postoperative period show different results. Physical activity seems to take longer to reach significantly improved values. By counting gait cycles, surgeons do have an additional tool to measure success after THA.
全髋关节置换术后患者的主观数据和体格检查用于评估手术效果。但对于身体活动情况，现有评分无法提供客观数据。活动水平可通过计算步态周期进行客观测量。本研究的目的是测量全髋关节置换术（THA）前后患者的活动水平。
本前瞻性研究纳入了46例患者。在手术前1周、术后6周和术后3个月评估西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、Harris髋关节评分（HHS）以及基于每日步数的身体活动水平。为评估患者的一般体质，测定了美国麻醉医师协会（ASA）评分和体重指数（BMI）。使用StepWatch 3™活动监测仪（SAM；美国华盛顿州西雅图市Orthocare Innovations公司）测量身体活动水平。评估每日的步态周期数。采用Spearman等级相关系数确定年龄、体重指数（BMI）、美国麻醉医师协会分级与步态周期数之间的关联，并检测步态周期数与HHS以及步态周期数与WOMAC之间的相关性。
从术前到术后6周，步态周期数无显著变化。术后3个月，每日和每小时的步态周期数显著改善。从手术前到6周及3个月随访时，HHS和WOMAC显著改善。在任何测量时间点，每日步态周期数均与HHS和WOMAC评分无相关性。年龄、BMI和ASA分级不影响结果。
通过使用StepWatch 3™活动监测仪，可以可靠地测量THA前后身体活动的客观数据。术后主观和客观数据显示出不同的结果。身体活动似乎需要更长时间才能达到显著改善的值。通过计算步态周期，外科医生在THA后有了一种额外的工具来衡量手术的成功与否。
