Preoperative prediction of early physical function in elder patients undergoing hip arthroplasty using a subjective physical activity questionnaire / 中国组织工程研究

ABSTRACT

BACKGROUND:Preoperative walking ability and activities are good predictors of functional recovery of patients after hip replacement. But these objective assessment tools are invalid to predict postoperative function of patients with no preoperative walking ability. OBJECTIVE:To assess the effect of preoperative subjective physical activity questionnaire to predict the 6-month postoperative physical functioning outcomes in elder patients receiving hip arthroplasty, and to determine which aspects of patient’s characteristics influence 6-month postoperative physical activity. METHODS:A two-center prospective audit was carried out in elder patients who underwent hip arthroplasty between November 2010 and February 2013. These patients were divided into three groups, including the group of total hip arthroplasty for fractures of the femoral neck, the group of total hip arthroplasty for osteoarthritis and the group of hemiarthroplasty for fractures of the femoral neck. Al patients had fulfil ed Longitudinal Aging Study Amsterdam-Physical Activity Questionnaire (LAPAQ) and Short Form 36 (SF-36) recal ing their physical activity at 2 weeks before the fal accident (for fractures of the femoral neck) or admission (for hip osteoarthritis). Preoperative demographic data were also col ected. Postoperative assessment regarding subjective physical activity assessment including LAPAQ and SF-36, and objective physical activity assessment including timed up and go test and six-minute walk test were evaluated at the time of 6-month postoperation. RESULTS AND CONCLUSION:Total y 115 patients finished the study. Both preoperative LAPAQ and SF-36 can play a predictor to probe 6-month postoperative function of objective and subjective activity in patients with femoral neck fractures or hip osteoarthritis undergoing hip arthroplasty. Preoperative LAPAQ seems better than preoperative SF-36 to predict postoperative physical activity. For hip fracture patients, because preoperative objective function cannot be assessed, preoperative LAPAQ can play an effective and subjective index to predict postoperative function of objective activity, and physical functions can recover 70%-80%at 6 months postoperatively. For hip osteoarthritis patients, postoperative physical function can be increased by approximately 27%compared with before hip arthroplasty. Patient’s characteristics also affect the postoperative physical activity, and the occurrence of preoperative complications is a most important factor.