Gait analysis and WOMAC are complementary in assessing functional outcome in total hip replacement

Area of Science:

• Orthopedics
• Biomechanical Engineering
• Rehabilitation Science

Background:

• Total hip replacement (THR) aims to restore function and alleviate pain in patients with hip osteoarthritis.
• Assessing patient recovery involves both subjective self-reports and objective biomechanical measures.
• The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) is a common patient-reported outcome measure.

Purpose of the Study:

• To investigate the correlation between subjective patient evaluations (WOMAC) and objective gait analysis parameters following total hip replacement.
• To determine if the WOMAC questionnaire adequately reflects functional recovery in terms of walking performance.

Main Methods:

• A prospective preliminary trial conducted at a German academic orthopaedic centre.
• Seventeen patients undergoing primary unilateral total hip replacement for hip osteoarthritis were included.
• The WOMAC questionnaire and gait analysis were performed preoperatively and three months postoperatively.

Main Results:

• Significant improvements were observed in both subjective health status (WOMAC, P < 0.0001) and objective gait parameters including gait speed (P = 0.0222), stride length (P = 0.038), and stance phase ratio (P = 0.0466).
• The correlation between baseline gait parameters and WOMAC scores was poor (r ≤ -0.27).
• Correlation between the changes in gait parameters and WOMAC scores ranged from poor to good (r = 0.01 to -0.72).

Conclusions:

• The WOMAC questionnaire alone may not accurately reflect the objective improvements in walking performance after total hip replacement.
• Gait analysis provides essential objective data on gait quality that complements subjective patient reports.
• Integrating both subjective and objective measures is recommended for a comprehensive evaluation of THR outcomes.