Relationship between preoperative hip range of motion and anxiety about dislocation after total hip arthroplasty

Atsushi Shinonaga , Hiromi Matsumoto , Mana Uekawa , Akiho Kuramoto , Shigeru Mitani , Hiroshi Hagino
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Abstract

Purpose

Following total hip arthroplasty (THA), anxiety about dislocation often limits patient's quality of life. However, the factors that cause anxiety about dislocation remain unclear. This study was an investigation of whether limited range of motion (ROM) at the hip before surgery is associated with anxiety about dislocation after THA.

Methods

A retrospective cohort study was performed using questionnaires and medical records. Questionnaires were mailed to 796 female patients who underwent THA at our hospital between April 2015 and August 2020. The questionnaire was to be self-administered and asked participants to select their level of anxiety about dislocation during activities of daily living from the following answer choices: non-anxious, anxious, and extremely anxious. Hip ROM was measured within 3 days before surgery. The association between anxiety about dislocation and hip ROM was evaluated using logistic regression analysis after adjusting for potentially relevant factors.

Results

In total, 513 (64.4%) patients responded to the questionnaire and were included in the analysis. Those patients who reporting feeling extremely anxious about dislocation after THA had limited hip flexion ROM. This association was independent of surgical approach and postoperative follow-up duration. A ROM of less than 80° during hip flexion was used to identify those respondents who reported extreme anxiety about dislocation.

Conclusion

The results of this study suggest that patients with a limited hip flexion ROM before THA may be extremely anxious about dislocation after THA.

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术前髋关节活动范围与全髋关节置换术后脱位焦虑的关系
目的全髋关节置换术后,对脱位的焦虑往往会限制患者的生活质量。然而,造成错位焦虑的因素尚不清楚。本研究旨在调查术前髋关节活动受限(ROM)是否与THA术后脱位焦虑有关。方法采用问卷调查和病历进行回顾性队列研究。问卷被邮寄给2015年4月至2020年8月期间在我院接受THA的796名女性患者。问卷是自我管理的,并要求参与者从以下答案中选择他们在日常生活活动中对错位的焦虑程度:不焦虑、焦虑和极度焦虑。术前3天测量髋关节ROM。在校正了潜在的相关因素后,使用逻辑回归分析评估了对脱位的焦虑与髋关节ROM之间的关系。结果共有513名(64.4%)患者对问卷进行了回复并纳入分析。那些报告对THA术后脱位感到极度焦虑的患者髋关节屈曲ROM有限。这种关联与手术方法和术后随访时间无关。髋关节屈曲过程中小于80°的ROM被用来识别那些报告对脱位极度焦虑的受访者。结论THA术前髋关节屈曲ROM有限的患者可能对THA术后脱位感到极度焦虑。
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