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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 2/2014

01-02-2014 | Symposium: 2013 Hip Society Proceedings

Muscle Strength and Functional Recovery During the First Year After THA

Authors: Dana L. Judd, PT, DPT, Douglas A. Dennis, MD, Abbey C. Thomas, PhD, ATC, Pamela Wolfe, MS, Michael R. Dayton, MD, Jennifer E. Stevens-Lapsley, PT, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 2/2014

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Abstract

Background

Patients undergoing total hip arthroplasty (THA) often are satisfied with the decrease in pain and improvement in function they achieve after surgery. Even so, strength and functional performance deficits persist after recovery, but these remain poorly characterized; knowledge about any ongoing strength or functional deficits may allow therapists to design rehabilitation programs to optimize recovery after THA.

Questions/purposes

The purposes of this study were to (1) evaluate postoperative muscle strength, function, and quality of life during the first year after THA; and (2) compare strength and function in patients 1 year after THA with a cohort of healthy peers.

Methods

Twenty-six patients undergoing THA were assessed 1, 3, 6, and 12 months postoperatively, and 19 adults with no hip pathology were tested as a control group. Isometric muscle strength (hip flexors, extensors, abductors, knee extensors, and flexors), functional performance (stair climbing, five times sit-to-stand, timed-up-and-go, 6-minute walk, and single-limb stance tests), and self-reported function (Hip Disability and Osteoarthritis Score, SF-36, and UCLA activity score) were compared.

Results

One month after THA, patients had 15% less hip flexor and extensor torque, 26% less abductor torque, 14% less knee extensor and flexor torque, and worse performance on the stair climbing, timed-up-and-go, single-limb stance, and 6-minute walk. Compared with healthy adults, patients 12 months after THA had 17% less knee extensor and 23% less knee flexor torque; however, the functional testing (including stair climbing, five times sit-to-stand, and the 6-minute walk) showed no significant differences with the patient numbers available between individuals undergoing THA and healthy control subjects. SF-36 Physical Component Scores, although significantly improved from preoperative levels, were significantly worse than healthy adults 1 year after THA (p < 0.01).

Conclusions

Patients experience early postoperative strength losses and decreased functional capacity after THA, yet strength deficits may persist after recovery. This may suggest that rehabilitation may be most effective in the first month after surgery.

Level of Evidence

Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
Muscle Strength and Functional Recovery During the First Year After THA
Authors
Dana L. Judd, PT, DPT
Douglas A. Dennis, MD
Abbey C. Thomas, PhD, ATC
Pamela Wolfe, MS
Michael R. Dayton, MD
Jennifer E. Stevens-Lapsley, PT, PhD
Publication date
01-02-2014
Publisher
Springer US
Published in
Clinical Orthopaedics and Related Research® / Issue 2/2014
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-013-3136-y

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