Kim Yuna, Kim Seo Young, Shim Sung Ryul, Hyun Jung Keun
Department of Rehabilitation Medicine, College of Medicine, Dankook University, Cheonan 31116, Republic of Korea.
Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon 35365, Republic of Korea.
J Clin Med. 2025 Mar 14;14(6):1979. doi: 10.3390/jcm14061979.
This paper's objective was to identify clinical predictors, especially modifiable ones, associated with postoperative gait recovery in total hip arthroplasty (THA) patients, utilizing propensity score weighting (PSW) to control confounding factors. This retrospective cohort study included 221 patients who underwent primary unilateral THA. We used PSW analysis to balance patient characteristics. Univariate and multivariate logistic regression analyses were applied to determine predictors of improved gait recovery, assessing variables such as age, gender, and postoperative muscle strength. Independent predictors of favorable gait recovery were male gender (Odds Ratio [OR]: 1.382; 95% Confidence Interval [CI]: 1.225-1.560; < 0.001), younger age (OR: 0.990 per year; 95% CI: 0.985-0.995; < 0.001), and postoperative hip flexor muscle strength greater than grade 3 (OR: 1.516; 95% CI: 1.177-1.953; = 0.002). Muscle strength emerged as a modifiable factor, suggesting that targeted rehabilitation may enhance functional outcomes. Enhancing hip flexor strength postoperatively could significantly improve gait recovery in THA patients. These findings support developing individualized rehabilitation strategies to optimize functional outcomes.
本文的目的是确定与全髋关节置换术（THA）患者术后步态恢复相关的临床预测因素，尤其是可改变的因素，利用倾向评分加权（PSW）来控制混杂因素。这项回顾性队列研究纳入了221例行初次单侧THA的患者。我们使用PSW分析来平衡患者特征。应用单因素和多因素逻辑回归分析来确定步态恢复改善的预测因素，评估年龄、性别和术后肌肉力量等变量。步态恢复良好的独立预测因素为男性（比值比[OR]：1.382；95%置信区间[CI]：1.225 - 1.560；<0.001）、年龄较小（OR：每年0.990；95%CI：0.985 - 0.995；<0.001）以及术后髋屈肌肌力大于3级（OR：1.516；95%CI：1.177 - 1.953；=0.002）。肌肉力量是一个可改变的因素，这表明针对性的康复训练可能会改善功能结局。术后增强髋屈肌力量可显著改善THA患者的步态恢复。这些发现支持制定个性化的康复策略以优化功能结局。
