Prediction of hip arthroplasty functional recovery
This prospective cohort study found that preoperative performance-based tests, in addition to conventional factors and comorbidity scores, can provide added value to prediction of functional recovery after total hip arthroplasty (THA).
With a rising demand for THA, there is also a rising need to control hospital length of stay (LOS) and identify patients in need of additional (preoperative) rehabilitation. Hospital discharge is partly decided by functional criteria like walking independence, but so far only subjective functional measures (e.g. the Risk Assessment and Prediction Tool, RAPT) are being utilized. This study aimed to determine the additional predictive value of objective performance-based tests for functional recovery after THA.
A total of 315 patients were assessed pre- and post-operatively using the RAPT tool, comorbidity score (Charnley score) and four performance-based tests (Timed Up and Go, 2-minute-walking, 10-meter-walking, and hand grip strength). A regression model was then used to determine which combination of tests and factors provided the best prediction of reaching the functional discharge criterion of walking independently for at least 4.6 metres within 3 days (normal LOS) or longer (delayed functional recovery).
The study found that addition of 2 performance-based tests added predictive value to conventional scores. Severe comorbidities (Charnley score C), older age (>70) and poor functional performance (TUG >10.5 s, 10MWT >10 s) were predictive of delayed functional recovery. Further research will need to confirm these single-centre findings in a multicentre study.
> From: Oosting et al., Disabil Rehabil 38 (2017) 1243-1249. All rights reserved to The Author(s). Click here for the online summary.