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Purpose <p>To investigate the association between preoperative extracellular water–to–total body water ratio (ECW/TBW) and time to walking independence among female patients undergoing total hip arthroplasty (THA).</p> Methods <p>This retrospective cohort study included female patients who underwent primary THA between January and December 2022. Preoperative ECW/TBW was measured using bioelectrical impedance analysis and dichotomized at 0.400. The primary outcome was time to walking independence within 14 postoperative days. Cox proportional hazards models assessed the association between ECW/TBW and walking independence, adjusting for age, comorbidities, nutritional status, skeletal muscle mass index, non-operated knee extensor strength, walking pain, and maximum walking speed. Model performance was evaluated using likelihood ratio tests, Harrell’s C-index, and time-dependent area under the curve (AUC).</p> Results <p>Among 142 patients, 118 (83.1%) achieved walking independence within 14&#xa0;days. Patients with ECW/TBW ≥ 0.400 achieved walking independence later than those with ECW/TBW &lt; 0.400 (log-rank p &lt; 0.001). In multivariable analysis, ECW/TBW ≥ 0.400 was associated with delayed walking independence (hazard ratio 0.29, 95% CI 0.16–0.52). Including ECW/TBW improved model fit and increased the time-dependent AUC at postoperative day 14.</p> Conclusion <p>Higher preoperative ECW/TBW is associated with delayed walking independence after THA and may complement preoperative assessment when predicting early postoperative functional recovery.</p>

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Association between preoperative extracellular water–to–total body water ratio and time to walking independence after total hip arthroplasty: a retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月29日

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  • Atsushi Shinonaga,
  • Hiromi Matsumoto,
  • Mana Uekawa,
  • Saki Kakeya,
  • Shuro Furuichi,
  • Shigeru Mitani,
  • Shigeharu Tanaka,
  • Naoki Deguchi,
  • Ryo Tanaka

摘要

Purpose

To investigate the association between preoperative extracellular water–to–total body water ratio (ECW/TBW) and time to walking independence among female patients undergoing total hip arthroplasty (THA).

Methods

This retrospective cohort study included female patients who underwent primary THA between January and December 2022. Preoperative ECW/TBW was measured using bioelectrical impedance analysis and dichotomized at 0.400. The primary outcome was time to walking independence within 14 postoperative days. Cox proportional hazards models assessed the association between ECW/TBW and walking independence, adjusting for age, comorbidities, nutritional status, skeletal muscle mass index, non-operated knee extensor strength, walking pain, and maximum walking speed. Model performance was evaluated using likelihood ratio tests, Harrell’s C-index, and time-dependent area under the curve (AUC).

Results

Among 142 patients, 118 (83.1%) achieved walking independence within 14 days. Patients with ECW/TBW ≥ 0.400 achieved walking independence later than those with ECW/TBW < 0.400 (log-rank p < 0.001). In multivariable analysis, ECW/TBW ≥ 0.400 was associated with delayed walking independence (hazard ratio 0.29, 95% CI 0.16–0.52). Including ECW/TBW improved model fit and increased the time-dependent AUC at postoperative day 14.

Conclusion

Higher preoperative ECW/TBW is associated with delayed walking independence after THA and may complement preoperative assessment when predicting early postoperative functional recovery.