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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 abduction 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 □ , see Figure 5
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Figure 0006: Postoperative abduction 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 □ , see Figure 5

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 significant difference between the latter 2 groups (Table 3). 6 weeks postoperatively, there were statistically significant differences in percentage muscle strength change compared to preoperative values between patients in the DLA and PA groups and between patients in the PA and AA groups, in favor of patients in the PA group. No statistically significant differences in muscle strength changes were found between the AA group and the DLA group at 6 weeks. At 3-month follow-up, there were no statistically significant muscle strength changes between any of the groups (Figure 6). At 3 months postoperatively, the abduction muscular strength was 15% less in the operated leg than in the unoperated leg (p < 0.001), with no statistically significant differences between 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 abduction 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 □ , see Figure 5
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0006: Postoperative abduction 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 □ , see Figure 5
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 significant difference between the latter 2 groups (Table 3). 6 weeks postoperatively, there were statistically significant differences in percentage muscle strength change compared to preoperative values between patients in the DLA and PA groups and between patients in the PA and AA groups, in favor of patients in the PA group. No statistically significant differences in muscle strength changes were found between the AA group and the DLA group at 6 weeks. At 3-month follow-up, there were no statistically significant muscle strength changes between any of the groups (Figure 6). At 3 months postoperatively, the abduction muscular strength was 15% less in the operated leg than in the unoperated leg (p < 0.001), with no statistically significant differences between 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