Effect of total hip arthroplasty on improving locomotive syndrome in hip disease patients: A prospective cohort study focused on total clinical decision limits stage 3

Shigeaki Miyazaki; Kurumi Tsuruta; Saori Yoshinaga; Yoichiro Yamaguchi; Yoshinori Fujii; Hideki Arakawa; Masaru Ochiai; Tsubasa Kawaguchi; Aya Unoki; Takero Sakamoto; Takuya Tajima; Yoshihiro Nakamura; Taro Funamoto; Masaru Hiyoshi; Etsuo Chosa

doi:10.1016/j.jos.2020.12.028

Effect of total hip arthroplasty on improving locomotive syndrome in hip disease patients: A prospective cohort study focused on total clinical decision limits stage 3

J Orthop Sci. 2022 Mar;27(2):408-413. doi: 10.1016/j.jos.2020.12.028. Epub 2021 Feb 25.

Authors

Affiliations

¹ Rehabilitation Unit, University of Miyazaki Hospital, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: 03-5-23@med.miyazaki-u.ac.jp.
² School of Nursing, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: hamham@med.miyazaki-u.ac.jp.
³ School of Nursing, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: saori_yoshinaga@med.miyazaki-u.ac.jp.
⁴ Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: yoichiroh_yamaguchi@med.miyazaki-u.ac.jp.
⁵ Department of Mathematics Education, Faculty of Education, University of Miyazaki, 1-1 Gakuen Kibanadai-nishi, Miyazaki, Miyazaki, 889-2192, Japan. Electronic address: yfujii@cc.miyazaki-u.ac.jp.
⁶ Rehabilitation Unit, University of Miyazaki Hospital, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: hideki_arakawa@med.miyazaki-u.ac.jp.
⁷ Rehabilitation Unit, University of Miyazaki Hospital, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: masaru_ochiai@med.miyazaki-u.ac.jp.
⁸ Rehabilitation Unit, University of Miyazaki Hospital, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: tsubasa_kawaguchi@med.miyazaki-u.ac.jp.
⁹ Rehabilitation Unit, University of Miyazaki Hospital, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: aya_unoki@med.miyazaki-u.ac.jp.
¹⁰ Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: takero@med.miyazaki-u.ac.jp.
¹¹ Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: ttajima@med.miyazaki-u.ac.jp.
¹² Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: yoshihiro_nakamura@med.miyazaki-u.ac.jp.
¹³ Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: taro_funamoto@med.miyazaki-u.ac.jp.
¹⁴ Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: masaru_hiyoshi@med.miyazaki-u.ac.jp.
¹⁵ Rehabilitation Unit, University of Miyazaki Hospital, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan; Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake Miyazaki, Miyazaki, 889-1692, Japan. Electronic address: chosa@med.miyazaki-u.ac.jp.

PMID: 33640221
DOI: 10.1016/j.jos.2020.12.028

Abstract

Background: In 2020, the Japanese Orthopaedic Association established a new stage 3 in clinical decision limits (CDL) to evaluate the stage of locomotive syndrome (LS). This study focused on total CDL stage 3 with the aim of investigating indicators related to improvements in total CDL by evaluating the improvement of LS in patients who underwent total hip arthroplasty (THA).

Methods: Of the 125 patients who underwent THA at our hospital, the subjects of the analysis were 105 patients determined to be total CDL stage 3 in an evaluation performed before THA. LS was evaluated using the stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale (GLFS-25). Indicators related to improvements in total CDL were also investigated. All evaluation items were measured before THA and three months after THA.

Results: Before THA, all subjects (n = 105) were classified as total CDL stage 3. Three months after THA, improvements in total CDL were seen in 49 subjects (46.7%). The results of stepwise multiple logistic regression analysis showed that the before THA stand-up test and GLFS-25 were significantly related to improvements in total CDL.

Conclusions: Three months after THA, improvements in LS were seen in approximately half of the subjects. The stand-up test and GLFS-25 can be used as indicators of improvement in total CDL.

Design: Prospective cohort study design.

MeSH terms

Aged
Arthroplasty, Replacement, Hip*
Exercise Test
Humans
Locomotion
Prospective Studies
Syndrome