Influencing Factors for Joint Awareness After Total Hip Arthroplasty: A Cross-Sectional Study

Year 2024, Volume: 10 Issue: 1, 97 - 106, 28.03.2024

Ayşenur Gökşen Remzi Çaylak Fatma Kübra Çekok Gizem İrem Kınıklı

https://doi.org/10.19127/mbsjohs.1415693

Abstract

Objective: Total hip arthroplasty (THA) is a common procedure nowadays, with hospitals easily reaching hundreds of surgeries a year and considering the cross-sectional nature. Joint awareness (JA) is indicative of the patient's adaptation and satisfaction after THA. The current study investigated the relationship between joint awareness, joint position sense (JPS), mobility level, activities of daily living, and hip pain level in patients with THA.
Methods: This is a cross-sectional study involving 50 individuals with THA (31.48±55.14 weeks post-surgery; mean age was 54.32±18.28 years). Factors related to joint awareness were examined with linear regression analysis. Hip Joint position sense (JPS) was measured with a digital inclinometer, pain level was measured with a Visual Analog Scale (VAS), joint awareness was assessed with the Forgotten Joint Score-12, and mobility level was assessed with the Parker Mobility Index.
Results: The factors that have a statistically significant effect on the joint awareness are age, pain, mobility, and BMI (p = 0.002, p = 0.040, p<0.001, p = 0.010, and p = 0.010, respectively). According to the Beta coefficients, it is seen that the independent variables with the highest effect in absolute terms are mobility (Beta = 0.599) and age (Beta = 0.448).
Conclusion: According to our results, younger patients were less adaptive to the artificial joint following THA. The mobility level was also a strong predictive factor in joint awareness. Physiotherapy and rehabilitation programs should focus on joint awareness in terms of age and mobility level in patients with THA.

Keywords

Arthroplasty, Joint Awareness, Age, Mobility, Proprioception

Ethical Statement

Ethic Approval: Ethics committee approval was received for this study from Tarsus University Non-Invasive Clinical Research Ethics Committee. (Decision number: 2022/07, Date: 10.05.2022).

Supporting Institution

Tarsus University Scientific Research Projects Coordination Unit supported this work. The project number is SBF.22.002. Funding budget was used for equipment support.

Thanks

The authors would like to thank all the people who accepted to participate in this study.

References

• Singh V, Bieganowski T, Huang S, Karia R, Davidovitch RI, Schwarzkopf R. The Forgotten Joint Score patient-acceptable symptom state following primary total hip arthroplasty. Bone Jt Open. 2022;3(4):307-313.
• Kawakami T, Imagama T, Matsuki Y, Okazaki T, Kaneoka T, Sakai T. Forgotten joint score is worse when the affected leg perceived longer than shorter after total hip arthroplasty. BMC Musculoskelet Disord. 2023;24(1):440.
• Shinonaga A, Matsumoto H, Uekawa M, Kuramoto A, Mitani S, Hagino H. Relationship Between Preoperative Psoas Major Muscle Quality and Forgotten Joint Score-12 in Patients After Total Hip Arthroplasty. Arthroplast Today. 2023;20:101118.
• Tripathy SK, Varghese P, Khan S, Neradi D, Jain M, Sen RK. Joint awareness among total hip arthroplasty patients operated through anterior approach versus posterior approach: a systematic review and meta-analysis. Eur J Orthop Surg Traumatol. 2023;34(1):39-46.
• Zhang F, Zhang Z, Fan H, Cheng Q, Guo H. Systematic evaluation of the degree of joint amnesia in patients after total hip arthroplasty with direct anterior approach (DAA) compared with posterior approach (PA). J Orthop Surg Res. 2024;19(1):1-9.
• Özçadırcı A, Öztürk F, Çağlar Ö, Coşkun G. Are kinesiophobia and functional performance related to ability to forget the artificial joint in patients with total hip arthroplasty? Clin Exp Health Sci. 2021;11(2):285-290.
• Colibazzi V, Coladonato A, Zanazzo M, Romanini E. Evidence based rehabilitation after hip arthroplasty. Hip Int. 2020;30(2_suppl):20-29.
• Ma X, Lu L, Zhou Z, Sun W, Chen Y, Dai G, et al. Correlations of strength, proprioception, and tactile sensation to return-to-sports readiness among patients with anterior cruciate ligament reconstruction. Front Physiol. 2022;13.
• Fähndrich E, Linden M. Reliability and validity of the Visual Analogue Scale (VAS). Pharmacopsychiatria. 1982;15(3):90-94.
• Behrend H, Giesinger K, Giesinger JM, Kuster MS. The “Forgotten Joint” as the ultimate goal in joint arthroplasty: Validation of a new patient-reported outcome measure. J Arthroplasty. 2012;27(3):430-436.e431.
• Kınıklı Gİ, Güney Deniz H, Karahan S, Yüksel E, Kalkan S, Dönder Kara D, et al. Validity and reliability of Turkish version of the Forgotten Joint Score-12. J Exerc Ther Rehabil. 2017;4(1):18-25.
• Stołowski Ł, Niedziela M, Lubiatowski B, Lubiatowski P, Piontek T. Validity and reliability of inertial measurement units in active range of motion assessment in the hip joint. Sensors. 2023;23(21):8782.
• Reddy RS, Tedla JS, Alshahrani MS, Asiri F, Kakaraparthi VN, Samuel PS, et al. Reliability of hip joint position sense tests using a clinically applicable measurement tool in elderly participants with unilateral hip osteoarthritis. Sci Rep. 2022;12:376-384.
• Voeten SC, Nijmeijer WS, Vermeer M, Schipper IB, Hegeman J, De Klerk G, et al. Validation of the Fracture Mobility Score against the Parker Mobility Score in hip fracture patients. Injury. 2020;51(2):395-399.
• Puliero B, Blakeney WG, Beaulieu Y, Vendittoli P-A. Joint perception after total hip arthroplasty and the forgotten joint. J Arthroplasty. 2019;34(1):65-70.
• Shanmugaraj A, Kumar MV, Al Naji O, Simunovic N, Philippon MJ, Ayeni OR. Hip arthroscopy improves outcomes with moderate conversion to total hip arthroplasty rates in patients aged 50 years or older: A systematic review. Arthroscopy. 2023;39(6):1539-1551.e1531.
• Mew L, Heaslip V, Immins T, Wainwright T. What is important to the younger person (≤50 years) when having a total hip arthroplasty: A systematic literature review. Orthop Nurs. 2023;42(4):213-229.
• Hiyama Y, Wada O, Nakakita S, Mizuno K. Joint awareness after total knee arthroplasty is affected by pain and quadriceps strength. Orthop Traumatol Surg Res. 2016;102(4):435-439.
• Kerin A, Patwari P, Kuettner K, Cole A, Grodzinsky A. Molecular basis of osteoarthritis: biomechanical aspects. Cell Mol Life Sci. 2002;59:27-35.
• Larsson A, Rolfson O, Kärrholm J. Evaluation of forgotten joint score in total hip arthroplasty with Oxford Hip Score as reference standard. Acta Orthop. 2019;90(3):253-257.
• Thienpont E, Vanden Berghe A, Schwab PE, Forthomme JP, Cornu O. Joint awareness in osteoarthritis of the hip and knee evaluated with the ‘Forgotten Joint’ Score before and after joint replacement. Knee Surg Sports Traumatol Arthrosc. 2016;24(10):3346-3351.
• Schotanus MGM, Pilot P, Vos R, Kort NP. No difference in joint awareness after mobile- and fixed-bearing total knee arthroplasty: 3-year follow-up of a randomized controlled trial. Eur J Orthop Surg Traumatol. 2017;27(8):1151-1155.
• Heath EL, Ackerman IN, Cashman K, Lorimer M, Graves SE, Harris IA. Patient-reported outcomes after hip and knee arthroplasty: results from a large national registry. Bone Jt Open. 2021;2(6):422-432.