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Are Harris Hip Scores and Gait Mechanics Related Before and After THA?

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Discordance between subjective and objective functional measures hinders the development of new ways to improve THA outcomes.

Questions/purposes

We asked if (1) any kinematic or kinetic gait variables are correlated with preoperative Harris hip scores (HHS), (2) any kinematic or kinetic gait variables are correlated with postoperative HHS, and (3) pre- to postoperative changes in any kinematic or kinetic gait variables are associated with the change in HHS?

Methods

For this retrospective study, an institutional review board-approved data repository that included all individuals who participated in motion analysis research studies was used to identify subjects evaluated before (n = 161) and at least 6 months after primary unilateral THA (n = 156). Selected kinematic (sagittal plane dynamic hip ROM and kinetic (peak external moments about the hip in the sagittal, frontal, and transverse planes) gait variables were collected at subjects’ self-selected normal walking speeds. We used first-order partial correlations to identify relationships between HHS and gait variables, controlling for the influence of speed.

Results

Preoperative HHS correlated with hip ROM (R|speed = 0.260; p < 0.001) and the peak extension moment (R|speed = 0.164; p = 0.038), postoperative HHS correlated with the peak internal rotation moment (R|speed = 0.178; p = 0.034), and change in HHS correlated with change in hip ROM (R|speed = 0.288; p = 0.001) and peak external rotation moment (R|speed = 0.291; p = 0.002). Similar associations were seen when the HHS pain and function were analyzed separately.

Conclusions

This study identified relationships between a common clinical outcome measure and specific, modifiable gait adaptations that can persist after THA—ROM and transverse plane gait moments. Addressing these aspects of gait dysfunction through focused rehabilitation could be a new strategy for improving clinical outcomes. Prospective studies are needed to evaluate this concept.

Level of Evidence

Level III, diagnostic study. See the Instructions for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Robert Trombley BS, Gary Farkas BS, and Markus Wimmer PhD, of the Rush University Medical Center Motion Analysis Laboratory for assistance with data acquisition.

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Authors and Affiliations

  1. Rush Medical College, Rush University Medical Center, Chicago, IL, USA

    Omar A. Behery MPH

  2. Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W Taylor, 650 AHSB, Chicago, IL, 60612, USA

    Kharma C. Foucher MD, PhD

Authors
  1. Omar A. Behery MPH
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  2. Kharma C. Foucher MD, PhD
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Corresponding author

Correspondence to Kharma C. Foucher MD, PhD.

Additional information

This work was partially supported by a Rush Research Mentoring Program Young Investigator Pilot Grant (KCF) and a Rush Medical College Dean’s Fellowship for Summer Research (OAB).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research ® editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research ® neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at Rush University Medical Center, Chicago, IL, USA.

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Behery, O.A., Foucher, K.C. Are Harris Hip Scores and Gait Mechanics Related Before and After THA?. Clin Orthop Relat Res 472, 3452–3461 (2014). https://doi.org/10.1007/s11999-014-3886-1

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