Patients performed less physical activity 2 years after THA despite improved function
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Despite significant improvements in postoperative gait function, published results showed patients were more sedentary, slept worse and performed less physical activity 2 years after total hip arthroplasty.
Researchers performed THA using a posterior surgical approach with a press-fit Trilogy acetabular shell and a cemented CPT femoral stem (Zimmer Biomet) in 51 patients between October 2016 and February 2018. Researchers captured 24-hour activity profiles preoperatively and at 1 year and 2 years postoperatively using a wrist-worn accelerometer, and performed 3D gait analysis to determine change in temporospatial and kinematic parameters of the hip and pelvis.
Results showed patients experienced improvements in all temporospatial and kinematic parameters with time. Researchers found patients were sedentary or asleep for a mean time of approximately 19.5 hours per day preoperatively, which remained unchanged up to 2 years postoperatively. Patients experienced suboptimal sleep efficiency at all time points, according to results. Researchers also noted patients had worse sleep efficiency at 2 years postoperatively compared with preoperatively. Results showed 32% and 41% of patients were sedentary for greater than 11 hours per day at 1 year and 2 years postoperatively, respectively.
Although patients accumulated their activity performing light activities, researchers found patients performed less light activity at 2 years postoperatively vs. preoperative levels. Researchers noted patients had no significant differences for moderate or vigorous activity across time.
“In conclusion, this study demonstrated that primary THA was a successful procedure to alleviate pain and improve physical performance during gait. Despite these improvements, patients did not change their free-living activity behavior postoperatively,” the authors wrote. “Evidently, a surgical procedure alone may not enable patients to lead a more physically active lifestyle, and health care providers must consider a multifaceted model of care, which includes patient education on the importance of reducing sedentary behaviors and addressing a range of barriers and facilitators to increase physical activity postoperatively.”
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