Shiomoto Kyohei, Hamai Satoshi, Hara Daisuke, Harada Satoru, Motomura Goro, Nakashima Yasuharu
Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Medical-Engineering Collaboration for Healthy Longevity, Kyushu University, Fukuoka, Japan.
J Arthroplasty. 2023 Feb;38(2):323-328. doi: 10.1016/j.arth.2022.08.034. Epub 2022 Aug 28.
There is increasing interest in improving activity after total hip arthroplasty (THA) and periacetabular osteotomy (PAO). The present study evaluated whether there were differences in the subjective and objective activity levels of THA and PAO patients at mean 12-year follow-up (range 4-20) and what factors influence the objective activity levels.
THA and PAO patients (30 patients each; mean age: 66 and 63 years, respectively), who had undergone surgery for osteoarthritis due to acetabular dysplasia, were included. Patients were retrospectively matched based on age, gender, body mass index, follow-up duration, and preoperative University of California, Los Angeles activity score (UCLA score). Patients were surveyed for the subjective activity levels using the Oxford Hip Score and UCLA score. Objective activity levels (the number of steps, upright time, and the number of sit-to-stand transitions) were made using an accelerometer.
There was no significant difference in subjective activity level between THA and PAO patients. The number of steps was significantly higher in PAO than in THA patients. Multivariable analyses revealed that THA and low Oxford Hip Score activities of daily living were negatively associated with the number of steps, that men and high UCLA score were negatively associated with upright time, and that high body mass index was negatively associated with sit-to-stand transitions in THA and PAO patients.
This study suggested that although there was no difference in postoperative subjective activity level between THA and PAO patients, there was a difference in objective activity level. Providing guidance to these patients based on objective activity may lead to higher activity levels.
全髋关节置换术(THA)和髋臼周围截骨术(PAO)后改善活动能力的关注度日益增加。本研究评估了在平均12年随访期(范围4 - 20年)时,THA和PAO患者的主观和客观活动水平是否存在差异,以及哪些因素会影响客观活动水平。
纳入因髋臼发育不良导致骨关节炎而接受手术的THA和PAO患者(各30例;平均年龄分别为66岁和63岁)。根据年龄、性别、体重指数、随访时间以及术前加利福尼亚大学洛杉矶分校活动评分(UCLA评分)对患者进行回顾性匹配。使用牛津髋关节评分和UCLA评分对患者的主观活动水平进行调查。使用加速度计测量客观活动水平(步数、直立时间和坐立转换次数)。
THA和PAO患者的主观活动水平无显著差异。PAO患者的步数显著高于THA患者。多变量分析显示,THA和低牛津髋关节评分的日常生活活动与步数呈负相关,男性和高UCLA评分与直立时间呈负相关,高体重指数与THA和PAO患者的坐立转换次数呈负相关。
本研究表明,虽然THA和PAO患者术后主观活动水平无差异,但客观活动水平存在差异。基于客观活动为这些患者提供指导可能会带来更高的活动水平。