Di Laura Frattura Giorgio, Bordoni Vittorio, Feltri Pietro, Fusco Augusto, Candrian Christian, Filardo Giuseppe
Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, Switzerland.
Occupational and Environmental Medicine, Università degli Studi di Milano, 20122 Milano, Italy.
Diagnostics (Basel). 2022 Mar 11;12(3):684. doi: 10.3390/diagnostics12030684.
Hip arthroplasty (HA) is the most common intervention for joint replacement, but there is no consensus in the literature on the real influence of this procedure on balance, or on what factors in the pre-operative, surgical, and post-operative stages may affect it.
To synthesize the evidence on how Hip Arthroplasty (HA) affects balance, identifying pre-operative, surgical, and postoperative risk factors that may impair balance in HA patients, with the aim to improve patients' management strategies.
A literature search was performed on PubMed, PeDRO, and Cochrane Collaboration on 25 May 2021.
clinical report of any level of evidence; written in English; with no time limitation; about balance changes in hip osteoarthritis (OA) patients undergoing HA and related factors.
27 papers (391 patients) were included. Overall, the evidence suggested that balance is impaired immediately after surgery and, 4-12 months after surgery, it becomes better than preoperatively, although without reaching the level of healthy subjects. A strong level of evidence was found for hip resurfacing resulting in better balance restoration than total HA (THA), and for strength and ROM exercises after surgery positively influencing balance.
Both the surgical technique and the post-operative protocols are key factors influencing balance; thus, they should be carefully evaluated when managing hip OA in patients undergoing HA. Moreover, balance at 4-12 months after surgery is better than preoperatively, although without reaching the level of the healthy population. Attention should be paid in the early post-operative phase, when balance may be impaired in patients undergoing HA.
髋关节置换术（HA）是关节置换最常见的干预手段，但对于该手术对平衡的实际影响，以及术前、手术中和术后阶段的哪些因素可能影响平衡，文献中尚无共识。
综合关于髋关节置换术（HA）如何影响平衡的证据，识别可能损害HA患者平衡的术前、手术和术后风险因素，以改善患者管理策略。
于2021年5月25日在PubMed、PeDRO和Cochrane协作网进行文献检索。
任何证据水平的临床报告；英文撰写；无时间限制；关于接受HA的髋骨关节炎（OA）患者的平衡变化及相关因素。
纳入27篇论文（391例患者）。总体而言，证据表明术后平衡立即受损，术后4至12个月时，平衡比术前有所改善，尽管未达到健康受试者的水平。有强有力的证据表明，髋关节表面置换术比全髋关节置换术（THA）能更好地恢复平衡，且术后力量和关节活动度锻炼对平衡有积极影响。
手术技术和术后方案都是影响平衡的关键因素；因此，在管理接受HA的髋OA患者时应仔细评估。此外，术后4至12个月时的平衡比术前更好，尽管未达到健康人群的水平。在术后早期阶段应予以关注，此时接受HA的患者平衡可能受损。
