3. Results
During the study period, 37 patients who underwent TOT gave their
consent and were recruited to participate in the study. Of these, 32
(86%) have completed the follow-up examinations and questionnaires 6-8
weeks following surgery and thus were included in the final analyses.
Background demographic characteristics are presented in Table 1. The
average age of study participants was 59.9 years. They were mostly
married (62.5%), living in an urban settlement (71.9%), and were
postmenopausal (68.8%) at the time of surgery. About a quarter of the
participants had a background of chronic cardiovascular morbidity or
hypertension, and 16% were previously diagnosed with diabetes mellitus
(Supplementary table 1).
IIQ-7 and UDI-6 questionnaires allowed assessment of changes in
symptom-severity following the TOT procedure (Table 2). IIQ-7 scores
decreased by 31.95 points (± 5.75; p < 0.001). Similarly,
summary scores of the UDI-6 questionnaire were significantly lower
following the procedure by an average of 25.27 points (± 4.49; p
< 0.001).
A statistically significant decrease in the physical component score of
the 12-item Short Form Health Survey (SF-12) was noticed after surgery
(41.82 to 38.64, p=0.018). A decrease in the mental component score
after the surgery was noticed as well, but it was not statistically
significant (results not shown in table).
Table 3 presents information regarding range of motion (ROM) of the hip
joint before and after TOT. A statistically significant deterioration in
ROM was observed in all cardinal movements of the hip, except for in the
internal rotation of the left hip. Right and left hip extension
decreased by 2.97 and 2.75 degrees respectively (p < 0.05 for
both legs). As for strength assessment of hip movements, an overall
trend of decreased strength was noticed, that was statistically
significant for hip adduction (Table 4).
The ”Get Up and Go” (for a fixed distance of 6-meters) and the 10mWT
were applied for the clinical assessment of walking gait. The ”Get Up
and Go” test did not show a significant change in times, before (mean
7.23 seconds ± 0.82) and after (mean 7.63 seconds ± 0.98) TOT (p=0.116).
Likewise, similar walking speed of 1.65-1.72 m/sec (p=0.088), was
observed before and after TOT (results not shown in a table).
Results from ”The Forgotten Joint Score” assessment revealed no
difference in patient’s awareness of their hip joint when performing
daily activities following surgery (0.63 before, vs. 0.65 after TOT,
p=0.68).
Finally, direct measurement of the lengths of both legs (distance from
the ASIS to the medial malleolus), showed an increase in length of
8.7-8.8 millimeters following TOT (p=0.001 for both legs).