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. 2025 Jun 11;14(12):4135.
doi: 10.3390/jcm14124135.

Balance and Mobility in Comparison to Patient-Reported Outcomes-A Longitudinal Evaluation After Total Hip and Knee Arthroplasty

Klemens Vertesich  1 , Kevin Staats  1 , Eleonora Schneider  1 , Madeleine Willegger  1 , Reinhard Windhager  1 , Christoph Böhler  1
Affiliations

Balance and Mobility in Comparison to Patient-Reported Outcomes-A Longitudinal Evaluation After Total Hip and Knee Arthroplasty

Klemens Vertesich et al. J Clin Med. .

Abstract

Background: Balance and gait are critical for functional recovery and fall prevention following total hip (THA) and knee arthroplasty (TKA). Despite improvements in pain and joint function, residual impairments often persist. The Timed Up and Go (TUG) test and Tinetti Performance-Oriented Mobility Assessment (POMA) objectively measure postoperative mobility and balance, while patient-reported outcome measures (PROMs) assess perceived function and well-being. This study longitudinally evaluates functional measurement and PROMs to explore their interrelationships and compare recovery trajectories in THA and TKA cohorts. Methods: In this prospective study, 22 THA and 21 TKA patients were assessed preoperatively and at 4-6 days, 6 weeks, 3 months, and 12 months postoperatively using TUG, Tinetti, Hip Disability and Osteoarthritis Outcome Score (HOOS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and clinical scores (Harris Hip Score (HHS) for THA, Knee Society Score (KSS) for TKA). Pearson correlation assessed relationships between measures. Results: Both cohorts demonstrated significant immediate postoperative declines in balance and mobility, recovering to baseline by 6 weeks and surpassing it by 3 and 12 months (p < 0.001). PROMs showed earlier and sustained improvements. Objective balance and mobility measures showed minimal correlation with PROMs but were highly interrelated from 6 weeks onward. Conclusions: THA and TKA patients experience early postoperative balance impairments, suggesting heightened fall risk, with functional recovery lagging behind perceived well-being, highlighting the need for cautious rehabilitation strategies.

Keywords: Tinetti performance-oriented mobility assessment; balance; mobility; patient-reported outcome measures; recovery; total hip arthroplasty; total knee arthroplasty.

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Conflict of interest statement

Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. M.W. reports honoraria for lectures and course instruction from Arthrex Inc. all of which are not related to this study. R.W. reports consulting fees from Johnson & Johnson, Medical Limited, Stryker European, and Operations Limited, and institutional agreements between the Medical University of Vienna and De Puy Synthes, Johnson & Johnson, all of which are not related to this study. C.B. reports honoraria for lectures and course instruction Johnson & Johnson and Medacta.

Figures

Figure 1
Figure 1
(a–d): Longitudinal trajectories of functional performance and patient-reported outcomes (PROMs) in the total hip arthroplasty (THA) cohort. Panels show mean and standard deviation scores for the Tinetti Performance-Oriented Mobility Assessment (POMA), the Timed Up and Go (TUG) test, the Hip Disability and Osteoarthritis Outcome Score (HOOS), and the Harris Hip Score (HHS) at baseline (pre), postoperative days 4–6 (post), six weeks (6 w), three months (3 m), and twelve months (12 m). Statistical comparisons to baseline are indicated as non-significant (n.s.), and *** p < 0.001.
Figure 2
Figure 2
(a–e): Longitudinal trajectories of functional performance and patient-reported outcomes (PROMs) in the total knee arthroplasty (TKA) cohort. Panels show mean and standard deviation scores for the Tinetti Performance-Oriented Mobility Assessment (POMA), the Timed Up and Go (TUG) test, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Knee Society Score (with separate pain (KSSp) and function (KSSf) subscales), at baseline (pre), postoperative days 4–6 (post), six weeks (6 w), three months (3 m), and twelve months (12 m). Statistical comparisons to baseline are indicated as non-significant (n.s.), * p < 0.05, ** p < 0.01, and *** p < 0.001.
Figure 3
Figure 3
Bar charts showing mean balance performance, as measured by the Tinetti Performance-Oriented Mobility Assessment (POMA), for the total hip arthroplasty group (solid gray bars) and the total knee arthroplasty group (hatched gray bars) at each evaluation time point (preoperative—preop, postoperative days 4–6—postop, six weeks—6 w, three months—3 m, and twelve months—12 m).
Figure 4
Figure 4
Bar charts showing mean mobility assessments, as measured by the Timed Up and Go (TUG) test, for the total hip arthroplasty group (solid gray bars) and the total knee arthroplasty group (hatched gray bars) at each evaluation time point (preoperative—preop, postoperative days 4–6—postop, six weeks—6 w, three months—3 m, and twelve months—12 m).
See this image and copyright information in PMC

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