International orthopaedics · 2026
Preoperative two-step test predicts independent ambulation one week after total hip arthroplasty.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Matsumoto Saki, Fujii Masanori, Higashijima Naoki, Takei Yasuo, Kishikawa Koichiro, Oba Yosuke, Ueno Masaya, Kawano Shunsuke, Morimoto Tadatsugu
Аннотация
PURPOSE: To identify preoperative physical performance and muscle quality factors associated with independent ambulation one week after total hip arthroplasty (THA).
METHODS: This retrospective study included 102 patients (102 hips) who underwent primary unilateral THA via a posterior approach between June 2024 and June 2025. Patients were classified into independent (n = 54) and dependent (n = 48) ambulation groups according to their ability to walk 50 m without walking aids one week after THA. Preoperative assessments included the 30-s chair-stand test, two-step test, one-leg stance time, and Timed Up and Go test, as well as computed tomography-derived muscle attenuation values. Multivariable logistic regression was performed to identify independent predictors of independent ambulation.
RESULTS: The independent ambulation group was younger and performed better on all four physical function tests (all p < 0.05). Muscle attenuation values differed only for the rectus femoris (p = 0.003). In multivariable analysis, the two-step value was the sole independent predictor of independent ambulation (per 0.1-unit increase: OR 1.33; 95% CI 1.02-1.74; p = 0.026). The optimal cutoff value was 0.95, with a sensitivity of 75%, specificity of 76%, and area under the receiver operating characteristic curve of 0.81.
CONCLUSION: Preoperative two-step test performance independently predicted independent ambulation one week after THA. A two-step value of 0.95 may help identify patients at risk of delayed walking recovery and facilitate preoperative risk stratification.
METHODS: This retrospective study included 102 patients (102 hips) who underwent primary unilateral THA via a posterior approach between June 2024 and June 2025. Patients were classified into independent (n = 54) and dependent (n = 48) ambulation groups according to their ability to walk 50 m without walking aids one week after THA. Preoperative assessments included the 30-s chair-stand test, two-step test, one-leg stance time, and Timed Up and Go test, as well as computed tomography-derived muscle attenuation values. Multivariable logistic regression was performed to identify independent predictors of independent ambulation.
RESULTS: The independent ambulation group was younger and performed better on all four physical function tests (all p < 0.05). Muscle attenuation values differed only for the rectus femoris (p = 0.003). In multivariable analysis, the two-step value was the sole independent predictor of independent ambulation (per 0.1-unit increase: OR 1.33; 95% CI 1.02-1.74; p = 0.026). The optimal cutoff value was 0.95, with a sensitivity of 75%, specificity of 76%, and area under the receiver operating characteristic curve of 0.81.
CONCLUSION: Preoperative two-step test performance independently predicted independent ambulation one week after THA. A two-step value of 0.95 may help identify patients at risk of delayed walking recovery and facilitate preoperative risk stratification.