scholarly journals Unrestricted Weight Bearing and Intensive Physiotherapy after Uncemented Total Hip Arthroplasty

2006 ◽  
Vol 95 (1) ◽  
pp. 55-60 ◽  
Author(s):  
H. Ström ◽  
K. Huss ◽  
S. Larsson

Background and Aims: The effectiveness of partial weightbearing after hip surgery has been questioned as well as the need of intensive physiotherapy. Material and Methods: 36 patients (average age 54.4, 19 women) operated with uncemented hip arthroplasty were randomized either to unrestricted weightbearing (UWB) combined with intensive physiotherapy or to partial weightbearing (PWB) for 3 months combined with a short self-training program. The load during walking and the muscle strength (MS) in abduction was measured preoperative and subsequent up to 12 months. Results: The average peak load on the operated leg at one week was 39.0 kg for the UWB and 25.8 for the PWB group (P = 0.009) while at three months 70.0 and 31.7 (P = 0.001) respectively. At 6 and 12 months there were no differences between the groups. The muscle strength increased in both groups up to six months but there were no differences between the groups. Conclusions: Even though patients applied more load than the recommended 15 kg most patients were able to comply with partial weightbearing fairly well. The effect of intensive physiotherapy on the muscle strength after hip arthroplasty is questionable.

2007 ◽  
Vol 78 (6) ◽  
pp. 730-738 ◽  
Author(s):  
Truike M Thien ◽  
Lennart Ahnfelt ◽  
Mikael Eriksson ◽  
Christer Strömberg ◽  
Johan Kärrholm

Author(s):  
Tomáš Vodička ◽  
Michal Bozděch ◽  
Marta Gimunová ◽  
Lenka Svobodová ◽  
Jiří Zháněl ◽  
...  

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.


2020 ◽  
Vol 4 (04) ◽  
pp. 155-157
Author(s):  
Michael Newman ◽  
David Hartwright

AbstractThe aim of this study was to assess a large, single-surgeon dataset of uncemented total hip arthroplasties that had been templated using software. This assessment compared preoperative templated predictions with what was implanted with regard to (1) femoral prosthesis size and (2) acetabular cup size. The operation notes for two types of uncemented total hip arthroplasty performed by a single surgeon between January 9, 2008, and March 21, 2019, were assessed. The data were refined so that only those that were fully templated on a correctly calibrated pelvic radiograph were included. This provided a total of 153 cases. The predicted software template was compared with actual implanted component sizes. With regard to the femoral stems, the templating software was exactly correct in 45.75% of cases and was accurate to within one size in 87.59% of cases. With regard to the acetabular component, the templating software was exactly correct in 52.94% of cases and was accurate to within one size (2 mm) in 86.94% of cases. Templating software offers an accurate prediction of the size of uncemented femoral and acetabular components. In addition, the benefits of templating include cognitive rehearsal, insight into potentially challenging aspects of surgery, and highlighting intraoperative issues where there is a large intraoperative deviation from what is templated. This study demonstrates the congruence and reproducibility of templating software when compared with other smaller studies performed in the literature.


2021 ◽  
Vol 10 (6) ◽  
pp. 1235
Author(s):  
Michael Fuchs ◽  
Marie-Anne Hein ◽  
Martin Faschingbauer ◽  
Mirco Sgroi ◽  
Ralf Bieger ◽  
...  

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.


2012 ◽  
Vol 64 (3) ◽  
pp. 415-423 ◽  
Author(s):  
Kristi Elisabeth Heiberg ◽  
Vigdis Bruun-Olsen ◽  
Arne Ekeland ◽  
Anne Marit Mengshoel

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