Vertesich Klemens, Staats Kevin, Schneider Eleonora, Willegger Madeleine, Windhager Reinhard, Böhler Christoph
Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
J Clin Med. 2025 Jun 11;14(12):4135. doi: 10.3390/jcm14124135.
Balance and gait are critical for functional recovery and fall prevention following total hip (THA) and knee arthroplasty (TKA). Despite improvements in pain and joint function, residual impairments often persist. The Timed Up and Go (TUG) test and Tinetti Performance-Oriented Mobility Assessment (POMA) objectively measure postoperative mobility and balance, while patient-reported outcome measures (PROMs) assess perceived function and well-being. This study longitudinally evaluates functional measurement and PROMs to explore their interrelationships and compare recovery trajectories in THA and TKA cohorts. In this prospective study, 22 THA and 21 TKA patients were assessed preoperatively and at 4-6 days, 6 weeks, 3 months, and 12 months postoperatively using TUG, Tinetti, Hip Disability and Osteoarthritis Outcome Score (HOOS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and clinical scores (Harris Hip Score (HHS) for THA, Knee Society Score (KSS) for TKA). Pearson correlation assessed relationships between measures. Both cohorts demonstrated significant immediate postoperative declines in balance and mobility, recovering to baseline by 6 weeks and surpassing it by 3 and 12 months ( < 0.001). PROMs showed earlier and sustained improvements. Objective balance and mobility measures showed minimal correlation with PROMs but were highly interrelated from 6 weeks onward. THA and TKA patients experience early postoperative balance impairments, suggesting heightened fall risk, with functional recovery lagging behind perceived well-being, highlighting the need for cautious rehabilitation strategies.
平衡和步态对于全髋关节置换术(THA)和膝关节置换术(TKA)后的功能恢复和预防跌倒至关重要。尽管疼痛和关节功能有所改善,但残余功能障碍往往仍然存在。定时起立行走(TUG)测试和Tinetti以性能为导向的移动性评估(POMA)客观地测量术后的移动性和平衡能力,而患者报告的结局指标(PROMs)则评估感知到的功能和健康状况。本研究纵向评估功能测量指标和PROMs,以探讨它们之间的相互关系,并比较THA和TKA队列中的恢复轨迹。在这项前瞻性研究中,对22例THA患者和21例TKA患者在术前以及术后4 - 6天、6周、3个月和12个月时进行评估,使用TUG、Tinetti、髋关节残疾和骨关节炎结局评分(HOOS)、膝关节损伤和骨关节炎结局评分(KOOS)以及临床评分(THA用Harris髋关节评分(HHS),TKA用膝关节协会评分(KSS))。Pearson相关性分析评估各项指标之间的关系。两个队列在术后即刻均表现出平衡和移动能力的显著下降,6周时恢复至基线水平,3个月和12个月时超过基线水平(<0.001)。PROMs显示出更早且持续的改善。客观的平衡和移动能力测量指标与PROMs的相关性极小,但从6周起两者高度相关。THA和TKA患者术后早期存在平衡功能障碍,提示跌倒风险增加,功能恢复落后于感知到的健康状况,这凸显了谨慎制定康复策略的必要性。