Association between Perioperative Walking Ability and Restoration of Life Space to Preoperative Levels 6 Months after Total Hip Arthroplasty.

Objectives: : Life space (LS) is an important indicator of functional recovery after total hip arthroplasty (THA). In this study, we aimed to investigate the association between restoration of LS to preoperative levels 6 months after THA and perioperative improvements in walking performance, adjusting for demographic and clinical factors. Methods: : This retrospective cohort study included 104 patients with hip osteoarthritis undergoing primary unilateral THA between January 2019 and April 2023. Participants were classified into restoration and non-restoration groups based on whether their LS returned to preoperative levels at 6 months postoperatively. Logistic regression analysis was conducted with LS restoration as the dependent variable, perioperative changes in gait speed as the main explanatory variable, and preoperative gait speed and preoperative LS score as covariates. Model performance was assessed using the area under the receiver operating characteristic (ROC) curve. Results: : LS repair was associated with improved gait speed during the perioperative period [odds ratio (OR) 18.3, 95% confidence interval (CI) 1.44-233.0], high preoperative gait speed (OR 9.4, 95% CI 2.28-69.0), and low preoperative LS score (OR 0.967, 95% CI 0.94-0.99). The predictive model demonstrated good discriminatory ability (area under the ROC curve 0.791; 95% CI 0.699-0.883). Conclusions: : Perioperative gait speed improvement and high preoperative walking ability are major factors associated with LS restoration after THA. Conversely, patients with low preoperative LS may have a higher potential for restoration. These findings emphasize the importance of targeted interventions aimed at improving ability to promote community mobility and independence after THA.