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Relevance of orthostatic posturography for clinical evaluation of hip and knee joint arthroplasty patients
Authors:Quagliarella Livio  Sasanelli Nicola  Monaco V  Belgiovine G  Spinarelli A  Notarnicola A  Moretti L  Moretti B
Affiliation:a Sezione di Ingegneria Biomedica, Dip. di Metodologia Clinica e Tecnologie Medico-Chirurgiche, Università degli Studi di Bari, Policlinico- P.zza G. Cesare 11, I-70124 Bari, Italy
b ARTS Lab, Scuola Superiore Sant’Anna, V.le Rinaldo Piaggio 34, I-56025 Pontedera, Italy
c U.O. Ortopedia e Traumatologia, Dip. di Metodologia Clinica e Tecnologie Medico-Chirurgiche, Università degli Studi di Bari, Policlinico- P.zza G. Cesare 11, I-70124 Bari, Italy
Abstract:In order to verify whether orthostatic posturography (OP) can support clinical assessment of total hip (THA) and knee arthroplasty (TKA), 81 subjects with THA and 100 with TKA were recruited and compared with 59 healthy volunteers. All patients were tested one or two days prior to surgery; 42 subjects (20 THA and 22 TKA) were tested again after six months, and 34 (14 THA and 20 TKA) yet again after 12 months. OP was performed using a Kistler 9286A piezoelectric force plate and the following postural parameters (PPs) were adopted on account of their functional meaning: mean velocity and the root mean square of the distance of the centre of pressure (CoP), sway area, and 95% of the CoP power frequency. Eye condition and fatigue related to the test duration were also examined. The three most meaningful PPs were identified and a logarithmic transformation was then applied to these, as well as standardization. Almost all the PP values were higher preoperatively in the patients as compared with the healthy subjects and it was possible to detect many statistically significant differences between patients and healthy subjects. However, when examining the 181 subjects at the preoperative stage, the PPs did not show congruence with the clinical scores as well as they did during follow-up. Therefore, the use of the OP is not recommended to monitor patients undergoing THA or TKA.
Keywords:Postural control   Clinical evaluation   Hip   Knee   Prostheses
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