Joint proprioception in the elderly with and without hip fracture.

Abstract

Decreased proprioception may contribute to the risk of falls in elderly patients. The purpose of this study is to determine whether patients with hip fractures have decreased hip proprioception compared with aged-matched controls, and whether hip proprioception differs in patients with repaired fractures compared with patients who have undergone prosthetic hip replacement after hip fracture. Retrospective. Both hips of twenty-four hip fracture patients and age-matched patients without hip fractures were studied. Hip fracture patients were divided into osteosynthesis (twelve hips) and hemiarthroplasty (twelve hips) groups. Reproducibility of index angles (thirty hip flexion and thirty hip abduction) were compared with a six-degree-of-freedom electrogoniometer (instrumented spatial linkage; angular accuracy +/-0.5 degrees). There was no significant difference (flexion, p > 0.20; abduction, p > 0.67) in joint proprioception between fracture and no fracture groups. Likewise, there was no difference (flexion, p > 0.99, abduction; p > 0.74) in joint proprioception between osteosynthesis and hemiarthroplasty groups. Joint proprioception of hip fracture patients was not found to be diminished compared with age-matched normal controls. Additionally, replacement of the femoral head did not reduce joint proprioception compared with osteosynthesis with an intact femoral head. Maintenance of the femoral head does not seem to be necessary for the maintenance of joint proprioception in elderly hip fracture patients.