Journals / Osmangazi Tıp Dergisi / 2026 / Cilt: 48 Sayı: 1

Predictive Value of Patient-Reported Outcomes for Functional Performance After Total Hip Arthroplasty

Total Kalça Artroplastisi Sonrası Hasta Bildirimli Sonuçların Fonksiyonel Performansı Öngörme Değeri

Yusuf Polat(ORDU ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ORTOPEDİ VE TRAVMATOLOJİ ANABİLİM DALI)0000-0002-1650-9712
Elif Aygun Polat(ORDU ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ, FİZYOTERAPİ VE REHABİLİTASYON BÖLÜMÜ)0000-0001-9634-0728
Pages
84–93
Publication Date
2025-12-15
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Combining PROMs with performance-based tests can provide a more comprehensive assessment, facilitating individualized rehabilitation strategies and early identification of patients at risk of poor functional recovery

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Total hip arthroplasty (THA) effectively reduces pain and restores function in hip osteoarthritis, yet discrepancies often remain between patient-reported outcomes (PROMs) and actual physical performance.
📊
Key Findings & Data:This study investigated whether PROMs are associated with, and can independently predict, performance-based mobility and balance after THA.
💡
Conclusion & Impact:Combining PROMs with performance-based tests can provide a more comprehensive assessment, facilitating individualized rehabilitation strategies and early identification of patients at risk of poor functional recovery
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Artroplasti · Replasman · Kalça

Abstract

Total hip arthroplasty (THA) effectively reduces pain and restores function in hip osteoarthritis, yet discrepancies often remain between patient-reported outcomes (PROMs) and actual physical performance. This study investigated whether PROMs are associated with, and can independently predict, performance-based mobility and balance after THA. Fifty patients (mean age 64 ± 7 years; 56% female) who underwent unilateral primary THA at least 12 months earlier were included. Assessments comprised the Oxford Hip Score (OHS), the 12-Item Short Form Health Survey (SF-12), and visual analog scales for rest and activity-related pain. Performance-based tests included the Timed Up and Go (TUG), Four Square Step Test (FSST), and 4-Meter Gait Speed (4MGS). Pearson correlation and multivariate linear regression analyses were conducted controlling for demographic and clinical variables. Activity-related pain demonstrated moderate correlations with TUG and FSST and a strong correlation with 4MGS, while OHS showed moderate negative correlations with TUG and FSST and a strong negative correlation with 4MGS. SF-12 physical scores correlated with TUG and 4MGS, whereas rest pain was not associated with any performance measure. Regression analyses revealed that OHS and activity-related pain were consistent independent predictors of all three performance tests, while age and comorbidities significantly predicted FSST outcomes. These findings suggest that PROMs, particularly OHS and activity-related pain, are closely related to objective performance measures and may independently predict postoperative mobility and balance after THA. Combining PROMs with performance-based tests can provide a more comprehensive assessment, facilitating individualized rehabilitation strategies and early identification of patients at risk of poor functional recovery

Özet

Total kalça artroplastisi (TKA), kalça osteoartritinde ağrıyı azaltmak ve fonksiyonu geri kazandırmak için etkili bir cerrahi yöntemdir, ancak hasta bildirimli sonuçlar (Patient-Reported Outcome Measures, PROMs) ile gerçek fiziksel performans arasında uyumsuzluk görülebilmektedir. Bu çalışma, PROM’ların mobilite ve denge performansı ile ilişkisini ve bağımsız öngördürücü değerini araştırmayı amaçladı. Çalışmaya tek taraflı primer TKA uygulanmış ve ameliyatın üzerinden en az 12 ay geçmiş 50 hasta (ortalama yaş 64 ± 7 yıl; %56 kadın) dahil edildi. Değerlendirmeler Oxford Kalça Skoru (Oxford Hip Score, OHS), 12 Maddelik Kısa Form Sağlık Anketi (12-Item Short Form Health Survey, SF-12) ve istirahat ile aktiviteye bağlı ağrı için görsel analog skalalarını içermekteydi. Performans testleri arasında Zamanlı Kalk ve Yürü Testi (Timed Up and Go, TUG), Dört Kare Adım Testi (Four Square Step Test, FSST) ve 4 Metre Yürüme Hızı (4-Meter Gait Speed, 4MGS) yer aldı. Demografik ve klinik değişkenler kontrol edilerek Pearson korelasyon ve çok değişkenli lineer regresyon analizleri uygulandı. Aktiviteye bağlı ağrı, TUG ve FSST ile orta, 4MGS ile güçlü korelasyon gösterirken; OHS, TUG ve FSST ile orta, 4MGS ile güçlü negatif korelasyon gösterdi. SF-12 fiziksel skorları TUG ve 4MGS ile ilişkiliydi, istirahat ağrısı ise hiçbir performans testi ile ilişkili bulunmadı. Regresyon analizlerinde OHS ve aktiviteye bağlı ağrı tüm testlerin bağımsız öngördürücüsü olurken, yaş ve kronik hastalık FSST’yi öngördürdü. Bulgular, özellikle OHS ve aktiviteye bağlı ağrının TKA sonrası mobilite ve dengeyi bağımsız olarak öngördüğünü göstermektedir. PROM’ların performans testleri ile birlikte kullanılması postoperatif değerlendirmenin güçlendirilmesine ve bireyselleştirilmiş rehabilitasyon stratejilerine katkı sağlayabilir.

🔖

Cite This Article

Polat, Y., Polat, E. A. (2025). Predictive Value of Patient-Reported Outcomes for Functional Performance After Total Hip Arthroplasty. Osmangazi Tıp Dergisi, Cilt: 48 Sayı: 1, 84–93. https://doi.org/10.20515/otd.1795514

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (29)

  1. Shan L, Shan B, Graham D, Saxena A. Total hip replacement: a systematic review and meta-analysis on mid-term quality of life. Osteoarthritis Cartilage. 2014;22(3):389-406.
  2. Anakwe RE, Jenkins PJ, Moran M. Predicting dissatisfaction after total hip arthroplasty: a study of 850 patients. J Arthroplasty. 2011;26(2):209-13.
  3. Yeo MGH, Goh GS, Chen JY, Lo N-N, Yeo S-J, Liow MHL. Are oxford hip score and western Ontario and McMaster Universities osteoarthritis index useful predictors of clinical meaningful improvement and satisfaction after total hip arthroplasty? J Arthroplasty. 2020;35(9):2458-64.
  4. Eisler T, Svensson O, Tengström A, Elmstedt E. Patient expectation and satisfaction in revision total hip arthroplasty. J Arthroplasty. 2002;17(4):457-62.
  5. Unnanuntana A, Mait JE, Shaffer AD, Lane JM, Mancuso CA. Performance-based tests and self-reported questionnaires provide distinct information for the preoperative evaluation of total hip arthroplasty patients. J Arthroplasty. 2012;27(5):770-5. e1.
  6. Lieberman JR, Dorey F, Shekelle P, Schumacher L, Thomas BJ, Kilgus DJ, et al. Differences between patients' and physicians' evaluations of outcome after total hip arthroplasty. JBJS. 1996;78(6):835.
  7. Gandhi R, Tsvetkov D, Davey JR, Syed KA, Mahomed NN. Relationship between self-reported and performance-based tests in a hip and knee joint replacement population. Clin Rheumatol. 2009;28:253-7.
  8. Kennedy D, Stratford PW, Pagura SM, Walsh M, Woodhouse LJ. Comparison of gender and group differences in self-report and physical performance measures in total hip and knee arthroplasty candidates. J Arthroplasty. 2002;17(1):70-7.
  9. Elibol N, Unver B, Karatosun V, Gunal I. Relationship between self-reported and performance-based tests in assessment of patients with total hip arthroplasty. Hip Int. 2018;28(5):566-70.
  10. Jenkinson C, Layte R, Jenkinson D, Lawrence K, Petersen S, Paice C, et al. A shorter form health survey: can the SF-12 replicate results from the SF-36 in longitudinal studies? J Public Health. 1997;19(2):179-86.
  11. Busato A, Röder C, Herren S, Eggli S. Influence of high BMI on functional outcome after total hip arthroplasty. Obes Surg. 2008;18(5):595-600.
  12. Moses MJ, Tishelman JC, Stekas N, Jevotovsky DS, Vasquez-Montes D, Karia R, et al. Comparison of patient reported outcome measurement information system with neck disability index and visual analog scale in patients with neck pain. Spine. 2019;44(3):E162-E7.
  13. Dawson J, Fitzpatrick R, Carr A, Murray D. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br. 1996;78(2):185-90.
  14. Tuğay BU, Tuğay N, Güney H, Hazar Z, Yüksel İ, Atilla B. Cross-cultural adaptation and validation of the Turkish version of Oxford hip score. Arch Orthop Trauma Surg. 2015;135:879-89.
  15. Ware JE, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med
  16. Soylu C, Kütük B. Reliability and validity of the Turkish version of SF-12 health survey. Turk Psikiyatri Derg. 2022;33(2):108.
  17. Garcia AV, Caballero G, Chaney GK, Marinakis K, Orizola A. What Psychological Factors Affect Return to Sports After Shoulder Stabilization Surgery? A Scoping Review. Clin J Sport Med. 2022:10.1097.
  18. Dite W, Temple VA. A clinical test of stepping and change of direction to identify multiple falling older adults. Arch Phys Med Rehabil. 2002;83(11):1566-71.
  19. Batting M, Barker K. Reliability and validity of the Four Square Step Test in patients with hip osteoarthritis before and after total hip replacement. Physiotherapy. 2019;105(2):244-53.
  20. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8.
  21. Uysal İ, Özden F, Tümtürk İ, Şimşek M. Does physical performance demonstrate patient-reported outcomes after lumbar spine surgery? BMC Musculoskelet Disord. 2024;25(1):1000.
  22. Fey CF, Hu T, Delios A. The measurement and communication of effect sizes in management research.Manag Organ Rev. 2023;19(1):176-97.
  23. Allen Butler R, Rosenzweig S, Myers L, Barrack RL. The Frank Stinchfield Award: the impact of socioeconomic factors on outcome after THA: a prospective, randomized study. Clin Orthop Relat Res. 2011;469(2):339-47.
  24. Karttunen N, Lihavainen K, Sipilä S, Rantanen T, Sulkava R, Hartikainen S. Musculoskeletal pain and use of analgesics in relation to mobility limitation among community‐dwelling persons aged 75 years and older. Eur J Pain. 2012;16(1):140-9.
  25. Overton M, Swain N, Falling C, Gwynne-Jones D, Fillingim R, Mani R. Activity-related pain predicts pain and functional outcomes in people with knee osteoarthritis: a longitudinal study. Front Pain Res (Lausanne). 2023;3:1082252.
  26. Fujita K, Makimoto K, Tabuchi Y, Matsunaga-Myoji Y, Mawatari M. Oxford hip scores, floor-sitting score trajectories, and postoperative satisfaction rates at 10 years after primary total hip arthroplasty. J Arthroplasty. 2023;38(12):2673-9.
  27. Dainty JR, Smith TO, Clark EM, Whitehouse MR, Price AJ, MacGregor AJ. Trajectories of pain and function in the first five years after total hip and knee arthroplasty: an analysis of patient reported outcome data from the National Joint Registry. Bone Joint J. 2021;103(6):1111-8.
  28. Moretti VM, Post ZD. Surgical approaches for total hip arthroplasty. Indian J Orthop. 2017;51(4):368-76.
  29. McAuley JP, Szuszczewicz ES, Young A, Engh Sr CA. Total hip arthroplasty in patients 50 years and younger. Clin Orthop Relat Res. 2004;418:119-25.