Home E-Weekly August 15, 2017

How Patients Move May Affect Outcomes After Hip Surgery

Published: August 14, 2017

UPWARD MOBILITY A patient who brings her knees together when she stands up may not recover as well from hip surgery.

Why do some arthroscopic hip surgery patients achieve so much better results than others? Researchers at Ohio State University think one factor may be the way patients move.

"Our preliminary finding is that patients with the best function after surgery are those that had the most normal movement patterns," says physical therapist and lead researcher Stephanie Di Stasi, PT, PhD, a research scientist and assistant professor of orthopedics.

Dr. Di Stasi and her team have been using 3D motion analysis to examine patients who are at least a year out from surgery — when results start to level out, she says. What they've found is that patients with the poorest recoveries tend to be those who had the most abnormal movement patterns. They're the patients, she says, who, among other things, bring their knees together when they stand up, who don't use their hips to propel themselves forward, and who tend to bend their trunks when they move.

Physicians who are trying to determine whether patients are good candidates for hip surgery typically have to evaluate a lot of factors in a relatively short time frame, she says, and "very little time is spent evaluating movement."

Is it worth a longer look?

"We're purely making associations at this point and the evidence is more anecdotal," she says, "but the premise would be that if you have impaired movement before surgery, it's likely those movement patterns will persist." And recovery may be impeded as a result.

"We don't want people who would benefit from surgery to avoid surgery," she says. But, she adds, posture and movement-based training might allow some patients to opt out of surgery, and the same training might improve recoveries for those who've had surgery.

Jim Burger

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