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Association between changes in global femoral offset after total hip arthroplasty and function, quality of life, and abductor muscle strength. A prospective cohort study of 222 patients.

Mahmood SS, Mukka SS, Crnalic S, Wretenberg P, Sayed-Noor AS - Acta Orthop (2015)

Bottom Line: These patients were divided into 3 groups according to the postoperative global FO of the operated hip compared to the contralateral hip, as measured on plain radiographs: the decreased FO group (more than 5 mm reduction), the restored FO group (within 5 mm restoration), and the increased FO group (more than 5 mm increment).All 3 groups improved (p < 0.001).When we adjusted these results with possible confounding factors, only global FO reduction was statistically significantly associated with reduced abductor muscle strength.

View Article: PubMed Central - PubMed

Affiliation: a Department of Surgical and Perioperative Sciences (Orthopedics) , Sundsvall and Norrland University Hospitals, Umeå University , Stockholm , Sweden.

ABSTRACT

Background and purpose: There is no consensus on the association between global femoral offset (FO) and outcome after total hip arthroplasty (THA). We assessed the association between FO and patients' reported hip function, quality of life, and abductor muscle strength.

Patients and methods: We included 250 patients with unilateral hip osteoarthritis who underwent a THA. Before the operation, the patient's reported hip function was evaluated with the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and quality of life was evaluated with EQ-5D. At 1-year follow-up, the same scores and also hip abductor muscle strength were measured. 222 patients were available for follow-up. These patients were divided into 3 groups according to the postoperative global FO of the operated hip compared to the contralateral hip, as measured on plain radiographs: the decreased FO group (more than 5 mm reduction), the restored FO group (within 5 mm restoration), and the increased FO group (more than 5 mm increment).

Results: All 3 groups improved (p < 0.001). The crude results showed that the decreased FO group had a worse WOMAC index, less abductor muscle strength, and more use of walking aids. When we adjusted these results with possible confounding factors, only global FO reduction was statistically significantly associated with reduced abductor muscle strength. The incidence of residual hip pain and analgesics use was similar in the 3 groups.

Interpretation: A reduction in global FO of more than 5 mm after THA appears to have a negative association with abductor muscle strength of the operated hip, and should therefore be avoided.

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Related in: MedlinePlus

Flow diagram for patients included. aFor exclusions, see text.
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Figure 0002: Flow diagram for patients included. aFor exclusions, see text.

Mentions: 286 consecutive patients were eligible for inclusion in the study. 21 patients were excluded because they had previous trauma/pain in the contralateral hip or spine and 15 patients refused to participate in the study, leaving 250 patients. At the end of the study, a complete set of results for 222 patients (78%) was available (115 males) (Figure 2). A cemented prosthesis was used in 176 patients (79%) and a non-cemented prosthesis in 46 patients.


Association between changes in global femoral offset after total hip arthroplasty and function, quality of life, and abductor muscle strength. A prospective cohort study of 222 patients.

Mahmood SS, Mukka SS, Crnalic S, Wretenberg P, Sayed-Noor AS - Acta Orthop (2015)

Flow diagram for patients included. aFor exclusions, see text.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940589&req=5

Figure 0002: Flow diagram for patients included. aFor exclusions, see text.
Mentions: 286 consecutive patients were eligible for inclusion in the study. 21 patients were excluded because they had previous trauma/pain in the contralateral hip or spine and 15 patients refused to participate in the study, leaving 250 patients. At the end of the study, a complete set of results for 222 patients (78%) was available (115 males) (Figure 2). A cemented prosthesis was used in 176 patients (79%) and a non-cemented prosthesis in 46 patients.

Bottom Line: These patients were divided into 3 groups according to the postoperative global FO of the operated hip compared to the contralateral hip, as measured on plain radiographs: the decreased FO group (more than 5 mm reduction), the restored FO group (within 5 mm restoration), and the increased FO group (more than 5 mm increment).All 3 groups improved (p < 0.001).When we adjusted these results with possible confounding factors, only global FO reduction was statistically significantly associated with reduced abductor muscle strength.

View Article: PubMed Central - PubMed

Affiliation: a Department of Surgical and Perioperative Sciences (Orthopedics) , Sundsvall and Norrland University Hospitals, Umeå University , Stockholm , Sweden.

ABSTRACT

Background and purpose: There is no consensus on the association between global femoral offset (FO) and outcome after total hip arthroplasty (THA). We assessed the association between FO and patients' reported hip function, quality of life, and abductor muscle strength.

Patients and methods: We included 250 patients with unilateral hip osteoarthritis who underwent a THA. Before the operation, the patient's reported hip function was evaluated with the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and quality of life was evaluated with EQ-5D. At 1-year follow-up, the same scores and also hip abductor muscle strength were measured. 222 patients were available for follow-up. These patients were divided into 3 groups according to the postoperative global FO of the operated hip compared to the contralateral hip, as measured on plain radiographs: the decreased FO group (more than 5 mm reduction), the restored FO group (within 5 mm restoration), and the increased FO group (more than 5 mm increment).

Results: All 3 groups improved (p < 0.001). The crude results showed that the decreased FO group had a worse WOMAC index, less abductor muscle strength, and more use of walking aids. When we adjusted these results with possible confounding factors, only global FO reduction was statistically significantly associated with reduced abductor muscle strength. The incidence of residual hip pain and analgesics use was similar in the 3 groups.

Interpretation: A reduction in global FO of more than 5 mm after THA appears to have a negative association with abductor muscle strength of the operated hip, and should therefore be avoided.

Show MeSH
Related in: MedlinePlus