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).