Research Progress on Gait and Balance Function in Patients after Total Hip Arthroplasty
DOI:
https://doi.org/10.54097/79wt6n34Keywords:
Total Hip Arthroplasty, Gait, Balance, RehabilitationAbstract
Total hip arthroplasty is regarded as the ultimate intervention for end-stage hip diseases, and its main role is to relieve pain and rebuild hip function. However, abnormal gait and balance disorders are still common in patients after surgery, and even leave dysfunction for a long time, which seriously affects the physiological function and social and psychological health of patients. In recent years, with the development of precision medicine and rehabilitation medicine, the research on gait and balance function of patients after total hip arthroplasty has attracted more and more attention, and the relevant research is becoming more refined and individualized. This article reviews the research progress of gait and balance function in patients after hip replacement by exploring the mechanism, influencing factors, adverse effects, evaluation methods and intervention strategies of gait and balance abnormalities in patients after hip replacement.
Downloads
References
References
[1] SNELL D L, DUNN J A, HOOPER G. Associations between pain, function and quality of life after total hip arthroplasty[J]. International journal of orthopaedic and trauma nursing, 2024,54: 101121.
[2] BONNEFOY-MAZURE A, PONCET A, GONZALEZ A, et al. Limping and patient satisfaction after primary total hip arthroplasty: a registry-based cohort study[J]. Acta Orthop, 2022,93: 602-608.
[3] LABANCA L, CIARDULLI F, BONSANTO F, et al. Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review[J]. BMC musculoskeletal disorders, 2021, 22 (1): 1055.
[4] BIAN A, MA Y, ZHOU X, et al. Association between sarcopenia and levels of growth hormone and insulin-like growth factor-1 in the elderly[J]. BMC musculoskeletal disorders, 2020,21(1): 214.
[5] MURPHY J, PAK S, SHTEYNMAN L, et al. Mechanisms and Preventative Strategies for Persistent Pain following Knee and Hip Joint Replacement Surgery: A Narrative Review[J]. International journal of molecular sciences, 2024,25(9): 4722.
[6] ISMAILIDIS P, KVARDA P, VACH W, et al. Abductor Muscle Strength Deficit in Patients After Total Hip Arthroplasty: A Systematic Review and Meta-Analysis[J]. The Journal of arthroplasty, 2021,36(8): 3015-3027.
[7] SEKITA J, TAKAHIRA N, WATANABE H, et al. Identifying Deficits in Hip and Knee Muscle Strength on the Surgical and Nonsurgical Sides in Women up to 12 Months After Total Hip Arthroplasty[J]. Phys Ther, 2024,104(10).
[8] JOHN S, WEIZEL D, HEUMANN A S, et al. Persisting inter-limb differences in patients following total hip arthroplasty four to five years after surgery? A preliminary cross-sectional study[J]. BMC Musculoskelet Disord, 2021,22(1): 230.
[9] LABANCA L, CIARDULLI F, BONSANTO F, et al. Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review[J]. BMC Musculoskelet Disord, 2021,22(1): 1055.
[10] SALAMANNA F, CARAVELLI S, MARCHESE L, et al. Proprioception and Mechanoreceptors in Osteoarthritis: A Systematic Literature Review[J]. J Clin Med, 2023,12(20).
[11] RODRIGUEZ C P, COSSINS J, BEESON D, et al. The Neuromuscular Junction in Health and Disease: Molecular Mechanisms Governing Synaptic Formation and Homeostasis [J]. Front Mol Neurosci, 2020,13: 610964.
[12] BAO Z, CUI C, LIU C, et al. Prevention of age-related neuromuscular junction degeneration in sarcopenia by low-magnitude high-frequency vibration[J]. Aging Cell, 2024,23(7): e14156.
[13] DEWOLF A H, SYLOS-LABINI F, CAPPELLINI G, et al. Neuromuscular Age-Related Adjustment of Gait When Moving Upwards and Downwards[J]. Front Hum Neurosci, 2021, 15: 749366.
[14] ALSHEHRI S, REDDY R S, ALSHAHRANI M S, et al. Unraveling the impact of kinesiophobia on proprioception and balance: Mediation by pain, mobility, and psychological wellbeing in post-total hip replacement recovery[J]. PLoS One, 2024,19(12): e314627.
[15] TEMPSKI J, KOTLAREK A, PEKALA J, et al. Variability and clinical anatomy of the superior gluteal nerve-A systematic review and meta-analysis[J]. J Anat, 2025,246(4): 467-478.
[16] ESBJORNSSON A C, NAILI J E. Functional movement compensations persist in individuals with hip osteoarthritis performing the five times sit-to-stand test 1 year after total hip arthroplasty[J]. J Orthop Surg Res, 2020,15(1): 151.
[17] TANAKA S, KAYAMOTO A, TERAI C, et al. Preoperative Sarcopenia Severity and Clinical Outcomes after Total Hip Arthroplasty[J]. Nutrients, 2024,16(13).
[18] QUEEN R M, SCHMITT D. Sex-Specific Difference in Dynamic Balance Following Total Hip Replacement[J]. Innov Aging, 2021,5(2): igab19.
[19] RUANGSOMBOON P, RUANGSOMBOON O, AL-OBAEDI O, et al. Impact of low body mass index on reoperation risk and complications after joint arthroplasty: a cohort study[J]. Int Orthop, 2025,49(7): 1587-1597.
[20] VINCENT H K, HORODYSKI M, GEAREN P, et al. Obesity and long term functional outcomes following elective total hip replacement[J]. Journal of orthopaedic surgery and research, 2012,7: 16.
[21] JUREWICZ A, GASIOROWSKA A, LEZNICKA K, et al. Do Diabetes and Genetic Polymorphisms in the COMT and OPRM1 Genes Modulate the Postoperative Opioid Demand and Pain Perception in Osteoarthritis Patients After Total Knee and Hip Arthroplasty?[J]. J Clin Med, 2025,14(13).
[22] CANKAYA D, INCI F, KARAKUS D, et al. Isokinetic performance and function are similar after total hip arthroplasty applied with a posterior or anterolateral approach: a randomised controlled trial[J]. Hip Int, 2023,33(1): 67-72.
[23] ULIVI M, ORLANDINI L, VITALE J A, et al. Direct superior approach versus posterolateral approach in total hip arthroplasty: a randomized controlled trial on early outcomes on gait, risk of fall, clinical and self-reported measurements [J]. Acta Orthop, 2021,92(3): 274-279.
[24] BIANCO P L, TRONCONI L P, BOLCATO V, et al. Leg Length Discrepancy After Total Hip Arthroplasty: A Review of Clinical Assessments, Imaging Diagnostics, and Medico-Legal Implications[J]. Healthcare (Basel), 2025, 13 (12).
[25] LI M Y, CAO W, SHA P X, et al. [Correlation between femoral offset, rotation center and leg length discrepancy after total hip arthroplasty based on digital analysis][J]. Zhongguo Gu Shang, 2024,37(4): 381-386.
[26] HU X, ZHENG N, HSU W, et al. Adverse effects of total hip arthroplasty on the hip abductor and adductor muscle lengths and moment arms during gait[J]. Journal of orthopaedic surgery and research, 2020,15(1): 315.
[27] HU X, ZHENG N, CHEN Y, et al. Optimizing the Femoral Offset for Restoring Physiological Hip Muscle Function in Patients With Total Hip Arthroplasty[J]. Front Bioeng Biotechnol, 2021,9: 645019.
[28] GUERRA M L, SINGH P J, TAYLOR N F. Early mobilization of patients who have had a hip or knee joint replacement reduces length of stay in hospital: a systematic review[J]. Clinical rehabilitation, 2015,29(9): 844-854.
[29] KOUW I, GROEN B, SMEETS J, et al. One Week of Hospitalization Following Elective Hip Surgery Induces Substantial Muscle Atrophy in Older Patients[J]. J Am Med Dir Assoc, 2019,20(1): 35-42.
[30] HIRATA M, OYAMA Y, SHIMODA N, et al. Preoperative Posterior Pelvic Tilt Angle is Associated with Decreased Gait Speed and Hip Function in Older Patients with Hip Osteoarthritis [J]. Prog Rehabil Med, 2025,10: 20250004.
[31] ADEBERO T, BOBOS P, SOMERVILLE L, et al. Implementation of falls risk evaluation at one-year after total hip arthroplasty: a cross-sectional study[J]. Arch Physiother, 2022,12(1): 16.
[32] XIE Y, LIU S, LI C, et al. The effect of an early ambulation program based on cognitive behavioral therapy for elderly patients with kinesiophobia after total hip arthroplasty[J]. Frontiers in medicine, 2026,13: 1741605.
[33] REINE S, XI Y, ARCHER H, et al. Effects of Depression, Anxiety, and Pain Catastrophizing on Total Hip Arthroplasty Patient Activity Level[J]. The Journal of arthroplasty, 2023,38(6): 1110-1114.
[34] SERGOORIS A, VERBRUGGHE J, De BAETS L, et al. Are contextual factors associated with activities and participation after total hip arthroplasty? A systematic review[J]. Annals of physical and rehabilitation medicine, 2023,66(5): 101712.
[35] FUJITA T, HAMAI S, HARA D, et al. Trendelenburg gait after total hip arthroplasty due to reduced muscle contraction of the hip abductors and extensors[J]. J Orthop, 2025,59: 57-63.
[36] ABD-ELTAWAB A E, ELSHERBINI D, EL N E, et al. Bilateral hip stability variation in the functional ambulation and kinetic parameters after total hip arthroplasty during leveled walking[J]. Front Bioeng Biotechnol, 2024,12: 1415645.
[37] HAFFER H, WANG Z, HU Z, et al. Does Total Hip Arthroplasty Affect Spinopelvic and Spinal Alignment?: A Prospective Observational Investigation[J]. Clinical spine surgery, 2022,35(8): E627-E635.
[38] MCKNIGHT B M, TRASOLINI N A, DORR L D. Spinopelvic Motion and Impingement in Total Hip Arthroplasty[J]. The Journal of arthroplasty, 2019,34(7S): S53-S56.
[39] BERGMAN L, GUENNA H A, NILSSON U, et al. The bumpy road to recovery: older adults' experiences during the first year after hip replacement surgery - a longitudinal qualitative study[J]. BMC Geriatr, 2025,25(1): 483.
[40] ZARONIAS K J, ARNOLD K E, HECHT C N, et al. Sarcopenia in total joint Arthroplasty: Risk factor for poor postoperative outcomes and higher costs of care[J]. J Orthop, 2025,69: 176-185.
[41] KLOOS A D, FRITZ N E, KOSTYK S K, et al. Clinimetric properties of the Tinetti Mobility Test, Four Square Step Test, Activities-specific Balance Confidence Scale, and spatiotemporal gait measures in individuals with Huntington's disease [J]. Gait Posture, 2014,40(4): 647-651.
[42] KURIHARA Y, OHSUGI H, MATSUDA T, et al. Early postoperative relationship between patient-reported outcome measures and gait biomechanical factors after total hip arthroplasty[J]. Gait Posture, 2022,91: 14-18.
[43] GRIP H, NILSSON K G, HAGER C K, et al. Does the Femoral Head Size in Hip Arthroplasty Influence Lower Body Movements during Squats, Gait and Stair Walking? A Clinical Pilot Study Based on Wearable Motion Sensors[J]. Sensors (Basel), 2019,19(14).
[44] MARTINEZ L, NOE N, SIMON H, et al. Stabilometric assessments of two rehabilitation protocols on postural parameters after posterior total hip arthroplasty: A prospective randomized comparative study[J]. Orthop Traumatol Surg Res, 2022,108(1): 103174.
[45] POHL T, BRAUNER T, WEARING S, et al. Effects of sensorimotor training volume on recovery of sensorimotor function in patients following lower limb arthroplasty[J]. BMC Musculoskelet Disord, 2015,16: 195.
[46] MATHEIS C, ST GGL T. Strength and mobilization training within the first week following total hip arthroplasty[J]. Journal of bodywork and movement therapies, 2018,22(2): 519-527.
[47] FRYDENDAL T, CHRISTENSEN R, MECHLENBURG I, et al. Generalizability of the Progressive Resistance Training versus Total Hip Arthroplasty (PROHIP) trial: a cross-sectional study of 402 patients in Denmark[J]. Acta orthopaedica, 2025,96: 698-705.
[48] KIM B, YIM J. Core Stability and Hip Exercises Improve Physical Function and Activity in Patients with Non-Specific Low Back Pain: A Randomized Controlled Trial[J]. The Tohoku journal of experimental medicine, 2020,251(3): 193-206.
[49] CHAUDHARI A M W, VAN HORN M R, MONFORT S M, et al. Reducing Core Stability Influences Lower Extremity Biomechanics in Novice Runners[J]. Medicine and science in sports and exercise, 2020,52(6): 1347-1353.
[50] TANAKA H, YAMADA N, KURISHIMA H, et al. Association between Hip Center Position and Isokinetic Hip Muscle Performance after Anterolateral Muscle-Sparing Total Hip Arthroplasty[J]. Medicina (Kaunas, Lithuania), 2022,58(4): 538.
[51] KLIKA A K, YAKUBEK G, PIUZZI N, et al. Neuromuscular Electrical Stimulation Use after Total Knee Arthroplasty Improves Early Return to Function: A Randomized Trial[J]. J Knee Surg, 2022,35(1): 104-111.
[52] SETOGUCHI D, KINOSHITA K, KAMADA S, et al. Hybrid Assistive Limb improves restricted hip extension after total hip arthroplasty[J]. Assistive technology: the official journal of RESNA, 2022,34(1): 112-120.
[53] OKU K, KAWAHARA I, SUGIOKA T, et al. Immediate effects of plantar vibration stimuli during static upright posture following total hip arthroplasty in females[J]. Somatosens Mot Res, 2020,37(4): 238-244.
[54] DUDONIENE V, ADOMAITYTE A, ZLIBINAITE L. Randomized controlled trial to compare conventional physiotherapy with task-oriented exercises after total hip replacement [J]. J Back Musculoskelet Rehabil, 2023,36(4): 947-955.
[55] CHEN G, YU D, WANG Y, et al. A Prospective Randomized Controlled Trial Assessing the Impact of Preoperative Combined with Postoperative Progressive Resistance Training on Muscle Strength, Gait, Balance and Function in Patients Undergoing Total Hip Arthroplasty[J]. Clinical interventions in aging, 2024,19: 745-760.
[56] MIYAZAKI S, YAMAKO G, ARAKAWA H, et al. Weight-shifting-based robot control system improves the weight-bearing rate and balance ability of the static standing position in hip osteoarthritis patients: a randomized controlled trial focusing on outcomes after total hip arthroplasty[J]. PeerJ, 2023, 11: e15397.
[57] GABADA R, JAWADE S, TIKHILE P. Proprioceptive Neuromuscular Facilitation (PNF)-Integrated Gait Rehabilitation Following Total Hip Arthroplasty[J]. Cureus, 2024, 16(4): e57854.
[58] CHEN X, LI X, ZHU Z, et al. Effects of progressive resistance training for early postoperative fast-track total hip or knee arthroplasty: A systematic review and meta-analysis[J]. Asian journal of surgery, 2021,44(10): 1245-1253.
[59] SAUERESSIG T, OWEN P J, ZEBISCH J, et al. Evaluation of Exercise Interventions and Outcomes After Hip Arthroplasty: A Systematic Review and Meta-analysis[J]. JAMA network open, 2021,4(2): e210254.
[60] KONNYU K J, THOMA L M, CAO W, et al. Prehabilitation for Total Knee or Total Hip Arthroplasty: A Systematic Review[J]. American journal of physical medicine & rehabilitation, 2023,102(1): 1-10.
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

