Total Kalça Artroplastisi Sonrası Hasta Bildirimli Sonuçların Fonksiyonel Performansı Öngörme Değeri

Öz

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.

Anahtar Kelimeler

• Artroplasti
• Replasman
• Kalça
• Hasta tarafından bildirilen sonuç ölçümleri
• Fiziksel fonksiyonel performans

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

Öz

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

Anahtar Kelimeler

• Arthroplasty
• Replacement
• Hip
• Patient reported outcome measures
• Physical Functional Performance

Kaynakça

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