Preoperative factors associated with long-distance walking ability one year after total hip arthroplasty: a prospective cohort study.

PURPOSE: This study aimed to identify preoperative predictors of the six-minute walk distance (6MWD) one year after primary unilateral total hip arthroplasty (THA).

METHODS

This prospective cohort study included 152 women with hip osteoarthritis who underwent primary unilateral THA between April 2016 and June 2024. Preoperative assessments included age, body mass index (BMI), pain intensity (numerical rating scale), Timed Up and Go (TUG) test, 6MWD, hip abductor strength, range of motion (ROM) in flexion and extension at the hip, presence of contralateral hip osteoarthritis, and gait pattern (independent/cane-assisted). The primary outcome was 6MWD at one year postoperatively. Univariate and multiple linear regression analyses were performed to identify independent preoperative predictors of the 6MWD at one year postoperatively.

RESULTS

All functional outcomes except BMI improved significantly at one year postoperatively. Multiple regression analysis identified age (β =  - 2.8, p = 0.001), BMI (β =  - 3.3, p = 0.049), preoperative 6MWD (β = 0.6, p = 0.001), and contralateral hip extension ROM (β = 2.8, p = 0.045) as independent predictors of 6MWD at one year postoperatively.

CONCLUSIONS

The 6MWD significantly improved one year after THA but not to the level observed in healthy individuals. Long-distance walking ability one year after THA is associated not only with systemic factors such as age, BMI, and preoperative endurance but also with contralateral hip extension ROM. The functional status of both lower limbs and global physical capacity should be considered when evaluating postoperative walking recovery.