Increased muscle strength limits postural sway during daily living activities in total hip arthroplasty patients

Loss of muscle strength characterizes the period before total hip arthroplasty (THA). Little is known about whether muscle strength imbalances caused by muscle strength decline could be considered another clinical predictor for THA. This study aimed to determine whether muscle imbalances may be used as a clinical predictor for THA surgery. Thirty-six participants were enrolled in the study. Eighteen patients had THA (THA group), while 18 were healthy elders (CON group). Ipsilateral (H/Q) and bilateral (% Def) muscle imbalances of the knee were assessed. THA patients showed impairment of the extensors on the affected extremity compared to those unaffected. A comparison between the groups proved there were weakened flexors in the THA group on both extremities. A comparison of the imbalances revealed a significant bilateral imbalance of the extensors and ipsilateral imbalance of both extremities in the THA group. We computed two logistic regressions using bilateral and ipsilateral imbalance as the predictors of THA surgery. We found that bilateral extensor imbalance may be used as a predictor for THA (Nagelkerke R2 = 0.22). A decrease of the bilateral extensors imbalance by 8% decreases the probability of THA by 8%. The most interesting finding is that the evaluation of the bilateral extensor imbalance may be used as another clinical predictor for THA.

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Abductor Muscle Force after Straight-Stem Compared to Short-Stem Total Hip Arthroplasty through a Modified Direct Lateral Approach: Functional Assessment of 70 Consecutive Patients of a Randomized Controlled Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm10061235 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1235

Author(s):

Michael Fuchs ◽

Marie-Anne Hein ◽

Martin Faschingbauer ◽

Mirco Sgroi ◽

Ralf Bieger ◽

...

Keyword(s):

Clinical Trial ◽

Muscle Strength ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Lateral Approach ◽

Short Stem ◽

Abductor Muscle ◽

Total Hip ◽

Straight Stem ◽

Direct Lateral Approach

Because of preservation of proximal femoral bone stock and minimized soft tissue trauma, short-stem implants are becoming increasingly important in total hip arthroplasty (THA). The postulated advantage regarding the functional outcome has not been verified. We hypothesized an increased abductor muscle strength by the use of a short-stem design. Seventy consecutive patients of a randomized clinical trial were included. Of these, 67 patients met the inclusion criteria after 12 months. Thirty-five patients received a standard straight stem and 32 patients a short-stem femoral component. All surgeries were performed by a modified direct lateral approach. Isometric muscle strength of the hip abductors was evaluated preoperatively 3 and 12 months after surgery. Harris hip score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated. After three months, there were no differences between the two groups; the abductor force was comparable to the preoperative initial values. After 12 months, a significant increase in muscle strength for the short stem patient group compared to preoperative baseline values was measured (straight-stem THA, 0.09 Nm/kg ± 0.4, p = 0.32; short-stem THA, 0.2 Nm/kg ± 0.3, p = 0.004). Comparison of the 12-month postoperative total HHS and WOMAC revealed no significant differences between both groups. A significant increase in hip abductor muscle strength 12 months after short-stem THA compared to conventional-stem THA was observed.

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Total Hip Arthroplasty: The Relationship between Posterolateral Reconstruction, Abductor Muscle Strength, and Femoral Offset

Journal of Orthopaedic Surgery ◽

10.1177/230949900401200205 ◽

2004 ◽

Vol 12 (2) ◽

pp. 164-167 ◽

Cited By ~ 51

Author(s):

T Yamaguchi ◽

M Naito ◽

I Asayama ◽

T Ishiko

Keyword(s):

Muscle Strength ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Abductor Muscle ◽

Femoral Offset ◽

Total Hip ◽

The Relationship

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Effects of rehabilitation and arthroplasty on the hip isometric muscle strength in patients with osteoarthritis of the hip

Medicinski pregled ◽

10.2298/mpns0906236j ◽

2009 ◽

Vol 62 (5-6) ◽

pp. 236-240 ◽

Cited By ~ 1

Author(s):

Slavica Jandric

Keyword(s):

Muscle Strength ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Gluteus Medius ◽

Treated Group ◽

Early Rehabilitation ◽

Control Group ◽

Osteoarthritis Of The Hip ◽

Total Hip ◽

Tensor Fasciae Latae

Introduction Periarticular muscles have a significant role in keeping the mobility and integrity of the hip joint. The aim of this article was to investigate the effects of the total hip arthroplasty and early rehabilitation on the muscle strength. Patients Three groups of examined persons (matched in relation to musculosceletal conditions, sex, age and occupation) were included in the investigation. The first group (40 of the involved hip) and the second group (with 33 involved hips) were groups of patients with late-stage of osteoarthritis of the hip. The first group of patients was managed conservatively and the second group operatively (total cemented hip endoprosthesis was performed). The third group was control group with 123 healthy hips. Material and methods The maximal voluntary isometric strength was measured with dynamometer. The muscle strength was tested in all three groups: in the first group of patients at the beginning and at the end of the therapy and in patients of the second group 6?3 months postoperatively. Results A significant improvement of the muscle strength was noted for the flexors (t=2.45, p<0.05), musculus tensor fasciae latae (t=2.35, p<0.05), extensors (t=2.85, p<0.01), adductors (t=3.02, p<0.01), external rotators (t=3.1, p<0.01), m. gluteus medius (t=5.28, p<0.001) and internal rotators (t=5.77, p<0.001) after total hip arthroplasty and early rehabilitation in comparison to the conservatively treated group. Conclusion The muscle strength in the patients with osteoarthritis of the hip after arthroplasty was significantly higher than after rehabilitation for all hip muscles but did not reach values of the strength of the muscles in the corresponding control group.

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Changes in Hip and Knee Muscle Strength in Patients Following Total Hip Arthroplasty

Journal of the Japanese Physical Therapy Association ◽

10.1298/jjpta.vol16_002 ◽

2013 ◽

Vol 16 (1) ◽

pp. 22-27 ◽

Cited By ~ 8

Author(s):

Yoshihiro FUKUMOTO ◽

Koji OHATA ◽

Rui TSUKAGOSHI ◽

Keiich KAWANABE ◽

Haruhiko AKIYAMA ◽

...

Keyword(s):

Muscle Strength ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Total Hip ◽

Knee Muscle ◽

Knee Muscle Strength

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Total Hip Arthroplasty for the Paralytic and Non-paralytic Side in Patient with Residual Poliomyelitis

The Open Orthopaedics Journal ◽

10.2174/1874325001610010105 ◽

2016 ◽

Vol 10 (1) ◽

pp. 105-110 ◽

Cited By ~ 1

Author(s):

Motoki Sonohata ◽

Masaru Kitajima ◽

Shunsuke Kawano ◽

Masaaki Mawatari

Keyword(s):

Muscle Strength ◽

Total Hip Arthroplasty ◽

Hip Joint ◽

Hip Arthroplasty ◽

Muscle Tone ◽

Hip Osteoarthritis ◽

Hip Pain ◽

Total Hip ◽

Early Results ◽

History Of

Background: Total hip arthroplasty (THA) for poliomyelitis is a problematic procedure due to difficulty in positioning the cup of the prosthesis in the true acetabulum and the risk of dislocation after THA due to the low muscle tone. Methods: We herein present a case of bilateral hip pain with a history of poliomyelitis. Radiograph showed bilateral hip osteoarthritis caused by hip dysplasia due to residual poliomyelitis in right hip joint or developing dysplasia of the hip joint in left hip joint. THA was performed to bilateral hip joints. Results: Six years after bilateral THA, bilateral hip pain significantly improved. Additionally, the muscle strength on the paralyzed right side partially improved. However, the muscle strength on the non-paralyzed left side did not significantly improve. No complications related to the surgery were observed. Conclusion: Promising early results were obtained for THA in our patient with residual poliomyelitis. However, surgeons should pay attention to the potential development of complications concerning THA that may arise due to the residual poliomyelitis.

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Fear of Falling Restricts Activities of Daily Living after Total Hip Arthroplasty: A One-Year Longitudinal Study

Clinical Gerontologist ◽

10.1080/07317115.2017.1364682 ◽

2017 ◽

Vol 41 (4) ◽

pp. 308-314 ◽

Cited By ~ 5

Author(s):

Koutatsu Nagai ◽

Hisashi Ikutomo ◽

Keiichi Tagomori ◽

Namika Miura ◽

Tadao Tsuboyama ◽

...

Keyword(s):

Longitudinal Study ◽

Total Hip Arthroplasty ◽

Activities Of Daily Living ◽

Hip Arthroplasty ◽

Daily Living ◽

Fear Of Falling ◽

Total Hip ◽

One Year

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A test model of hip brace for prevention of dislocation after total hip arthroplasty (Zetton Band)

Prosthetics and Orthotics International ◽

10.1080/03093640208726656 ◽

2002 ◽

Vol 26 (3) ◽

pp. 253-256 ◽

Cited By ~ 4

Author(s):

S. Irie ◽

H. Iida ◽

H. Nishimatsu ◽

C. Hayashi ◽

T. Nakamura

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Daily Living ◽

Test Model ◽

Revision Total Hip Arthroplasty ◽

Total Hip ◽

Short Period ◽

Fixation Techniques ◽

Postoperative Dislocation ◽

Intractable Problem

Hip dislocations remain an intractable problem in patients with soft tissue impairment, particularly in those with muscle weakness around the hip, such as those who have undergone revision total hip arthroplasty (THA). At the authors’ hospital, postoperative dislocations were observed in 10 of 154 hips between January 1985 and June 1988. Five hips required re-replacement. Conventional measures to prevent or treat post-THA dislocations have been anti-dislocation pants for soft fixation and a cast or abduction-forcing braces for firm fixation. However, the anti-dislocation pants for soft fixation were not as effective as indicated by the above 10 postoperative dislocations. The firm fixation techniques are considered to cause a reduction in muscle strength, causing psychological stress and poor activity of daily living (ADL). The authors devised a soft brace for easy application and prepared its test model to prevent muscle weakening, allow stability of the hip during rotation and avoid restrictions in ADL. This brace was applied to a patient who had 3 dislocations in a short period after being discharged who sustained a postoperative dislocation and achieved good results.

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