scholarly journals 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

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.

scholarly journals Short-stem total hip arthroplasty is not associated with an earlier return to work compared to a straight-stem design

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Georg Hauer ◽  
Maria Smolle ◽  
Sabrina Zaussinger ◽  
Joerg Friesenbichler ◽  
Andreas Leithner ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Sick Leave ◽  
Return To Work ◽  
Hip Arthroplasty ◽  
Short Stem ◽  
Multivariate Linear Regression Analysis ◽  
Stem Design ◽  
Total Hip ◽  
Straight Stem ◽  
Significant Difference

AbstractReturn to work (RTW) has been specifically identified as a high priority in patients undergoing total hip arthroplasty (THA). This investigation sought to assess the effect of the stem design on patients’ RTW. Secondly, the study aimed to identify risk factors that lead to a delayed RTW. Questionnaires inquiring about RTW, employment history, educational level, type of work, physical demands and joint awareness were administered by post. Further data were collected from patients’ hospital records. 176 patients who underwent THA using a short-stem and 97 patients using a straight-stem design were compared. The median return to work time was 10 weeks [IQR 7–14 weeks], with no significant difference between the two groups (short stems vs. straight stems; 10 [IQR 7–14] vs. 11 [7.5–13.5] weeks; p = 0.693). In the multivariate linear regression analysis, self-employment vs. employee (p = 0.001), dimension of preoperative workload (p = 0.001), preoperative sick leave (p < 0.001), and hospital length of stay (LOS) (p < 0.001) independently affected the period until work was resumed. The Forgotten-Joint-Score-12 showed no significant difference between the two groups. The data show that the majority of THA patients can expect to resume work and stem design has no impact on RTW. Employees with preoperative sick leave, prolonged hospital LOS and low workload are at higher risk for a delayed RTW.

Effect of Superior Placement of the Hip Center on Abductor Muscle Strength in Total Hip Arthroplasty

2009 ◽  
Vol 24 (2) ◽  
pp. 240-245 ◽  
Author(s):  
Takahiko Kiyama ◽  
Masatoshi Naito ◽  
Hiroshi Shitama ◽  
Akira Maeyama
Keyword(s):  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Abductor Muscle ◽  
Total Hip

scholarly journals Fully hydroxyapatite-coated collared femoral stems in direct anterior versus direct lateral hip arthroplastyFully hydroxyapatite-coated collared femoral stems in direct anterior versus direct lateral hip arthroplasty

2021 ◽  
Vol 64 (2) ◽  
pp. E205-E210
Author(s):  
Sebastian Heaven ◽  
Maxwell Perelgut ◽  
Edward Vasarhelyi ◽  
James Howard ◽  
Matthew Teeter ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Lateral Approach ◽  
Early Recovery ◽  
Total Hip ◽  
Significant Difference ◽  
Femoral Stems ◽  
Direct Lateral Approach

Background: Total hip arthroplasty (THA) via the direct anterior approach has increased in popularity in the last decade, with research supporting enhanced early recovery; however, some investigators have reported increased early revision rates in direct anterior THA. We examined outcomes from a single institution’s experience with a fully hydroxyapatite-coated collared femoral stem implanted via the anterior or the lateral approach. Methods: Patients who had received fully hydroxyapatite-coated collared femoral stems as part of THA surgery performed by 1 of 3 surgeons between January 2012 and September 2017 were identified from our institutional database. We examined revision rates for the 2 approaches and compared them between the 2 groups. We also analyzed outcomes on plain film radiographs obtained immediately postoperatively and at 1 and 2 years. Results: A total of 695 patients received a fully hydroxyapatite-coated collared stem during the study period. Total hip arthroplasty was performed via the direct anterior approach in 281/778 hips (36.1%) and via the direct lateral approach in 497 (63.9%). Nineteen patients (2.5%) underwent subsequent revision surgery; there was no statistically significant difference in the revision rate between the anterior and lateral approaches (2.5% v. 2.4%, p = 0.95). The mean subsidence of the stem at 1 year was 1.68 mm (standard deviation 11.7 mm). No statistically significant differences were observed between the cohorts for any of the radiographic measurements at either follow-up time. Conclusion: We found no significant difference in revision rates between the direct anterior and direct lateral approach. Stem subsidence levels were in keeping with expected values, and no major changes in stem position occurred during the first postoperative year. Surgical approach did not appear to substantially affect biomechanical stem behaviour.

scholarly journals Incorporating Specific Functional Strength Integration Techniques to Improve Functional Performance for Veterans After Total Hip Arthroplasty: Protocol for a Randomized Clinical Trial

2019 ◽  
Vol 99 (11) ◽  
pp. 1453-1460
Author(s):  
Dana L Judd ◽  
Victor A Cheuy ◽  
Jeri E Forster ◽  
Cory L Christiansen ◽  
Jennifer E Stevens-Lapsley
Keyword(s):  
Clinical Trial ◽  
Physical Therapy ◽  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Resistance Exercise ◽  
Physical Function ◽  
Hip Arthroplasty ◽  
Functional Performance ◽  
Total Hip ◽  
Movement Compensation

Abstract Background Total hip arthroplasty (THA) is a common procedure, yet persistent deficits in functional performance exist after surgery. These deficits may be related to movement compensations observed after THA, which negatively affect quality of life and may increase morbidity and health care utilization, including in the veteran population. However, the best rehabilitative approach to remediating movement compensations and physical function deficits has not been determined. Objective The objective is to determine if a functional strength integration intervention (FSI), as part of a post-THA rehabilitation program, improves movement compensation, physical function, muscle strength, and self-reported outcome measures more than a control group (CON) undergoing a standard of care exercise program. Design This is a 2-arm randomized, controlled clinical trial. Setting The Veteran Affairs outpatient physical therapy clinics and academic research laboratory will be the settings. Participants One hundred veterans undergoing THA for hip osteoarthritis will be included in the study. Interventions Participants will be randomized to either the FSI or CON group and participate in visits of physical therapy over 8 weeks. The FSI protocol will include targeted exercise to improve muscular control and stability around the hip and trunk to minimize movement compensation during daily activity combined with progressive resistance exercise. The CON protocol will include patient education, flexibility activity, and low load resistance exercise. Measurements Functional performance, muscle strength and endurance, and self-reported outcomes will be measured at baseline (prior to surgery), midway through intervention (6 weeks after surgery), at the end of intervention (10 weeks after surgery), and 26 weeks after THA. Limitations The inability to blind treating therapists to study arm allocation is a limitation. Conclusions The proposed study aims to determine if targeted FSI can affect movement compensation to improve functional outcomes after THA more than traditional rehabilitation paradigms.

scholarly journals A Modified Direct Lateral Approach in Total Hip Arthroplasty

2002 ◽  
Vol 10 (1) ◽  
pp. 35-39 ◽  
Author(s):  
V.S. Pai
Keyword(s):  
Total Hip Arthroplasty ◽  
Learning Curve ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Lateral Approach ◽  
Fractured Neck Of Femur ◽  
Neck Of Femur ◽  
Total Hip ◽  
Direct Lateral Approach

A modified lateral approach of Hardinge allows adequate access for orientation of the implant was described. Although this approach is more difficult than the posterior approach, there is a learning curve, when mastered, it'll definitely reduce the incidence of dislocation. In the Author's opinion, this approach should be used routinely for total hip arthroplasty for fractured neck of femur where the incidence of dislocation is unacceptably high using the posterior approach.

scholarly journals Pelvic Inclination Angle and Hip Abductor Muscle Strength after Total Hip Arthroplasty

2013 ◽  
Vol 25 (2) ◽  
pp. 215-219 ◽  
Author(s):  
Akiko Kamimura ◽  
Harutoshi Sakakima ◽  
Masashi Miyazaki ◽  
Megumi Sakasegawa ◽  
Kosei Ijiri ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Inclination Angle ◽  
Hip Arthroplasty ◽  
Abductor Muscle ◽  
Total Hip ◽  
Pelvic Inclination ◽  
Hip Abductor
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