Baía Sul Hospital, Florianópolis, Santa Catarina, Brazil.
Department of Surgery, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil.
Gait Posture. 2019 Sep;73:52-64. doi: 10.1016/j.gaitpost.2019.07.124. Epub 2019 Jul 2.
Hip osteoarthritis is one of the major causes of disability worldwide, and although total hip arthroplasty is considered effective in the management of this condition, its effects on postural balance remain unclear.
What are the effects of total hip arthroplasty for primary hip osteoarthritis on the postural balance compared to preoperative status and/or to healthy controls?.
A systematic review was conducted, and the Embase, Latin American and Caribbean Health Sciences (LILACS), PubMed, Scopus, The Cochrane Library, and Web of Science databases were searched. Randomized and non-randomized studies were considered eligible for inclusion. The risk of bias of included studies was assessed using the Joanna Briggs Institute critical appraisal tools.
Among the 41 potentially eligible studies, 13 studies were included for qualitative synthesis-8 studies had low risk of bias and 5 had moderate risk of bias. Ten studies compared the effects of total hip arthroplasty on the postural balance in healthy controls. Meanwhile, the remaining 3 studies compared such effects to the preoperative status only. Comparable results on the postural balance between the intervention and control groups were observed in 5 studies, whereas 3 studies showed better scores among healthy controls. The other 2 studies reported that postural balance could still be impaired at 6 months to 3 years postoperatively. All 3 studies with no healthy controls reported an improvement in the postural balance compared to the preoperative status.
Major post-surgical improvements were consistently observed compared to preoperative status, although postural balance impairment was still noted compared to healthy controls.
The results of this study might be a useful guide for clinicians on the extent of the therapeutic effects of hip arthroplasty on postural balance. Furthermore, the standardization of balance assessment tools could strengthen the certainty of cumulative evidence in future studies.
髋骨关节炎是全球范围内导致残疾的主要原因之一，尽管全髋关节置换术被认为是治疗这种疾病的有效方法，但它对姿势平衡的影响仍不清楚。
与术前状态和/或健康对照组相比，原发性髋骨关节炎的全髋关节置换术对姿势平衡有什么影响？
进行了系统评价，并检索了 Embase、拉丁美洲和加勒比健康科学（LILACS）、PubMed、Scopus、The Cochrane Library 和 Web of Science 数据库。纳入了随机和非随机研究。使用 Joanna Briggs 研究所的批判性评估工具评估纳入研究的偏倚风险。
在 41 篇潜在合格的研究中，有 13 篇研究被纳入定性综合分析-8 篇研究的偏倚风险较低，5 篇研究的偏倚风险为中度。10 项研究比较了全髋关节置换术对健康对照组姿势平衡的影响。同时，其余 3 项研究仅比较了这种影响与术前状态。在 5 项研究中观察到干预组和对照组之间的姿势平衡结果相当，而 3 项研究显示健康对照组的得分更好。另外 2 项研究报告术后 6 个月至 3 年内姿势平衡仍可能受损。所有 3 项无健康对照组的研究报告与术前状态相比，平衡得到了改善。
与术前状态相比，术后的改善是显著的，但与健康对照组相比，仍然存在姿势平衡受损的情况。
本研究的结果可能为临床医生提供关于髋关节置换术对平衡治疗效果的有用指南。此外，平衡评估工具的标准化可以加强未来研究中累积证据的确定性。
