Predictive Factors for Gait Recovery in Patients Undergoing Total Hip Arthroplasty: A Propensity Score Weighting Analysis

<b>Objectives:</b> This paper's objective was to identify clinical predictors, especially modifiable ones, associated with postoperative gait recovery in total hip arthroplasty (THA) patients, utilizing propensity score weighting (PSW) to control confounding factors. <b>Methods:</b> This retrospective cohort study included 221 patients who underwent primary unilateral THA. We used PSW analysis to balance patient characteristics. Univariate and multivariate logistic regression analyses were applied to determine predictors of improved gait recovery, assessing variables such as age, gender, and postoperative muscle strength. <b>Results:</b> Independent predictors of favorable gait recovery were male gender (Odds Ratio [OR]: 1.382; 95% Confidence Interval [CI]: 1.225-1.560; <i>p</i> < 0.001), younger age (OR: 0.990 per year; 95% CI: 0.985-0.995; <i>p</i> < 0.001), and postoperative hip flexor muscle strength greater than grade 3 (OR: 1.516; 95% CI: 1.177-1.953; <i>p</i> = 0.002). Muscle strength emerged as a modifiable factor, suggesting that targeted rehabilitation may enhance functional outcomes. <b>Conclusions:</b> Enhancing hip flexor strength postoperatively could significantly improve gait recovery in THA patients. These findings support developing individualized rehabilitation strategies to optimize functional outcomes.