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Muscular strength after total hip arthroplasty. A prospective comparison of 3 surgical approaches.

Winther SB, Husby VS, Foss OA, Wik TS, Svenningsen S, Engdal M, Haugan K, Husby OS - Acta Orthop (2015)

Bottom Line: The posterior and anterior approaches produced less decrease in muscular strength than the direct lateral approach. 6 weeks postoperatively, the posterior approach produced greater increase in muscular strength than the direct lateral approach, and resulted in a greater increase in abduction strength than the anterior approach.At 3-month follow-up, no statistically significant differences between the groups were found.THA patients have reduced muscle strength in the operated leg (compared to the unoperated leg) 3 months after surgery.

View Article: PubMed Central - PubMed

Affiliation: a 1 Orthopaedic Research Centre, Orthopaedic Department, Trondheim University Hospital , Trondheim.

ABSTRACT

Background and purpose: Minimizing the decrease in muscular strength after total hip arthroplasty (THA) might allow patients to recover faster. We evaluated muscular strength in patients who were operated on using 3 surgical approaches. PATIENTS AND METHODs: In a prospective cohort study, 60 patients scheduled for primary THA were allocated to the direct lateral, posterior, or anterior approach. Leg press and abduction strength were evaluated 2 weeks or less preoperatively, 2 and 8 days postoperatively, and at 6-week and 3-month follow-up.

Results: Differences in maximal strength change were greatest after 2 and 8 days. The posterior and anterior approaches produced less decrease in muscular strength than the direct lateral approach. 6 weeks postoperatively, the posterior approach produced greater increase in muscular strength than the direct lateral approach, and resulted in a greater increase in abduction strength than the anterior approach. At 3-month follow-up, no statistically significant differences between the groups were found. The operated legs were 18% weaker in leg press and 15% weaker in abduction than the unoperated legs, and the results were similar between groups.

Interpretation: The posterior and anterior approaches appeared to have the least negative effect on abduction and leg press muscular strength in the first postoperative week; the posterior approach had the least negative effect, even up to 6 weeks postoperatively. THA patients have reduced muscle strength in the operated leg (compared to the unoperated leg) 3 months after surgery.

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Postoperative leg-press strength compared with preoperative values (100%) in the direct lateral approach (DLA) group, the posterior approach (PA) group, and the anterior approach (AA) group. #, Δ , and □ show statistically significant differences in percent change relative to preoperative values between groups.
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Figure 0005: Postoperative leg-press strength compared with preoperative values (100%) in the direct lateral approach (DLA) group, the posterior approach (PA) group, and the anterior approach (AA) group. #, Δ , and □ show statistically significant differences in percent change relative to preoperative values between groups.

Mentions: At 2 and 8 days postoperatively, patients in the DLA group had a statistically significantly larger reduction in muscular strength relative to the preoperative level than did the patients in the PA and AA groups, with no statistically significant difference between the PA and AA groups at 2 and 8 days postoperatively (Table 2). At 6 weeks postoperatively, there was still a statistically significant difference in percentage muscle strength change compared to preoperative values between the DLA group and the PA group, in favor of patients in the PA group. No statistically significant differences were found between patients in the AA group and patients in the PA group at 6 weeks, or between patients in the DLA and AA groups at 6 weeks. At 3-month follow-up, no statistically significant changes in muscle strength were found between any of the groups (Figure 5). 3 months postoperatively, the leg-press muscular strength was 18% less in the operated leg than in the unoperated leg (p < 0.001), with no differences between the groups.


Muscular strength after total hip arthroplasty. A prospective comparison of 3 surgical approaches.

Winther SB, Husby VS, Foss OA, Wik TS, Svenningsen S, Engdal M, Haugan K, Husby OS - Acta Orthop (2015)

Postoperative leg-press strength compared with preoperative values (100%) in the direct lateral approach (DLA) group, the posterior approach (PA) group, and the anterior approach (AA) group. #, Δ , and □ show statistically significant differences in percent change relative to preoperative values between groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940587&req=5

Figure 0005: Postoperative leg-press strength compared with preoperative values (100%) in the direct lateral approach (DLA) group, the posterior approach (PA) group, and the anterior approach (AA) group. #, Δ , and □ show statistically significant differences in percent change relative to preoperative values between groups.
Mentions: At 2 and 8 days postoperatively, patients in the DLA group had a statistically significantly larger reduction in muscular strength relative to the preoperative level than did the patients in the PA and AA groups, with no statistically significant difference between the PA and AA groups at 2 and 8 days postoperatively (Table 2). At 6 weeks postoperatively, there was still a statistically significant difference in percentage muscle strength change compared to preoperative values between the DLA group and the PA group, in favor of patients in the PA group. No statistically significant differences were found between patients in the AA group and patients in the PA group at 6 weeks, or between patients in the DLA and AA groups at 6 weeks. At 3-month follow-up, no statistically significant changes in muscle strength were found between any of the groups (Figure 5). 3 months postoperatively, the leg-press muscular strength was 18% less in the operated leg than in the unoperated leg (p < 0.001), with no differences between the groups.

Bottom Line: The posterior and anterior approaches produced less decrease in muscular strength than the direct lateral approach. 6 weeks postoperatively, the posterior approach produced greater increase in muscular strength than the direct lateral approach, and resulted in a greater increase in abduction strength than the anterior approach.At 3-month follow-up, no statistically significant differences between the groups were found.THA patients have reduced muscle strength in the operated leg (compared to the unoperated leg) 3 months after surgery.

View Article: PubMed Central - PubMed

Affiliation: a 1 Orthopaedic Research Centre, Orthopaedic Department, Trondheim University Hospital , Trondheim.

ABSTRACT

Background and purpose: Minimizing the decrease in muscular strength after total hip arthroplasty (THA) might allow patients to recover faster. We evaluated muscular strength in patients who were operated on using 3 surgical approaches. PATIENTS AND METHODs: In a prospective cohort study, 60 patients scheduled for primary THA were allocated to the direct lateral, posterior, or anterior approach. Leg press and abduction strength were evaluated 2 weeks or less preoperatively, 2 and 8 days postoperatively, and at 6-week and 3-month follow-up.

Results: Differences in maximal strength change were greatest after 2 and 8 days. The posterior and anterior approaches produced less decrease in muscular strength than the direct lateral approach. 6 weeks postoperatively, the posterior approach produced greater increase in muscular strength than the direct lateral approach, and resulted in a greater increase in abduction strength than the anterior approach. At 3-month follow-up, no statistically significant differences between the groups were found. The operated legs were 18% weaker in leg press and 15% weaker in abduction than the unoperated legs, and the results were similar between groups.

Interpretation: The posterior and anterior approaches appeared to have the least negative effect on abduction and leg press muscular strength in the first postoperative week; the posterior approach had the least negative effect, even up to 6 weeks postoperatively. THA patients have reduced muscle strength in the operated leg (compared to the unoperated leg) 3 months after surgery.

Show MeSH
Related in: MedlinePlus