Functional assessment in patients undergoing total hip arthroplasty.

Aims: Conventional patient-reported surveys, used for patients undergoing total hip arthroplasty (THA), are limited by subjectivity and recall bias. Objective functional evaluation, such as gait analysis, to delineate a patient's functional capacity and customize surgical interventions, may address these shortcomings. This systematic review endeavours to investigate the application of objective functional assessments in appraising individuals undergoing THA.
Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied. Eligible studies of THA patients that conducted at least one type of objective functional assessment both pre- and postoperatively were identified through Embase, Medline/PubMed, and Cochrane Central database-searching from inception to 15 September 2023. The assessments included were subgrouped for analysis: gait analysis, motion analysis, wearables, and strength tests.
Results: A total of 130 studies using 15 distinct objective functional assessment methods (FAMs) were identified. The most frequently used method was instrumented gait/motion analysis, followed by the Timed-Up-and-Go test (TUG), 6 minute walk test, timed stair climbing test, and various strength tests. These assessments were characterized by their diagnostic precision and applicability to daily activities. Wearables were frequently used, offering cost-effectiveness and remote monitoring benefits. However, their accuracy and potential discomfort for patients must be considered.
Conclusion: The integration of objective functional assessments in THA presents promise as a progress-tracking modality for improving patient outcomes. Gait analysis and the TUG, along with advancing wearable sensor technology, have the potential to enhance patient care, surgical planning, and rehabilitation.
Competing Interests: M. P. Ast reports royalties or licenses from OrthAlign, consulting fees from BD Biosciences, Bioventus, Confirmis, OrthAlign, Convatec, Smith & Nephew, Stryker, and Surgical Care Affiliates, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from BD Biosciences, OrthAlign, Smith & Nephew, and Stryker, stock or stock options from ConveyMED, HS2, OrthAlign, Ospitek, Osso VS, and Parvizi Surgical Innovations, all of which are unrelated to this study. J. M. Vigdorchik reports royalties or licenses from Corin and DePuy Synthes, consulting fees from DePuy Synthes, Stryker, and Intellijoint Surgical, stock or stock options from Aware, Corin, Intellijoint Surgical, Motion Insights, Ortho AI, and Polaris, and is a member of the editorial board of The Bone & Joint Journal, all of which are unrelated to this study. E. M. Debbi reports royalties or licenses from Ortho Development, consulting fees from DePuy Synthes, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Ortho Development, and stock or stock options in Think Surgical, all of which are unrelated to this study.
(© 2024 The British Editorial Society of Bone & Joint Surgery.)