Association between physical measures of spinopelvic alignment and physical functioning with patient reported outcome measures after total hip arthroplasty: Systematic review and narrative synthesis
Bibliographic record
Abstract
BACKGROUND: The prevalence of total hip arthroplasty (THA) is increasing, making optimizing post-surgery outcomes essential. Co-occurrence of low back pain (LBP) is frequently reported. Patient-reported outcome measures (PROMs) are commonly used to evaluate outcomes but have limitations, and physical measures may have value. This study evaluated association between 1] physical measures of spinopelvic alignment (measuring from spine to the pelvis) and physical functioning with PROMs after THA, and 2] physical measures with LBP. METHODS: Systematic review (PROSPERO: CRD42023412744) searched electronic databases, grey literature, and key journals to 31/5/2024 for cross-sectional and longitudinal studies assessing associations following THA. Two independent reviewers evaluated eligibility, extracted data, and assessed risk of bias (RoB, NIH tool). Owing to heterogeneity, a narrative synthesis was conducted, and GRADE determined overall quality. RESULTS: Fifty-one studies were included: 8 low-RoB, 24 moderate-RoB, 19 high-RoB. The evidence on spinopelvic alignment was extremely limited (6 studies), with the main synthesis focusing predominantly on physical measures of physical functioning. Very low-quality evidence supports no cross-sectional association between walking speed with function in short-term, and between light-intensity physical activity with patient-reported physical activity in medium-term. Very low-quality evidence supports no longitudinal association between Timed-Up-and-Go change with pain/function change, and Stair-Climb-Test (SCT) change with pain/function change in short-term, and SCT change with function change in medium-term. Other findings were inconsistent. Three LBP studies could not be synthesized due to heterogeneity. CONCLUSIONS: Very low-quality evidence supports no association between physical measures of physical functioning with PROMs, with limited LBP studies. There was significant heterogeneity, with few low ROB studies, highlighting a need for future research on the association between the measures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.032 | 0.145 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.011 | 0.010 |
| Bibliometrics | 0.011 | 0.011 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".