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Muscle Strength and Functional Recovery During the First Year After THA

  • Symposium: 2013 Hip Society Proceedings
  • Published:
Clinical Orthopaedics and Related Research®

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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Acknowledgments

We thank Jessica Shenk PT, DPT, for assisting with data collection and entry and Andrew Kittelson PT, DPT, for assisting with data entry. We also thank our patients for their time and participation.

Author information

Authors and Affiliations

  1. Physical Therapy Program, University of Colorado, Anschutz Medical Campus, 13121 E 17th Avenue, Mail Stop C244, Aurora, CO, 80045, USA

    Dana L. Judd PT, DPT, Abbey C. Thomas PhD, ATC & Jennifer E. Stevens-Lapsley PT, PhD

  2. Colorado Center for Joint Replacement, Denver, CO, USA

    Douglas A. Dennis MD

  3. Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA

    Pamela Wolfe MS

  4. Department of Orthopaedics, University of Colorado, Aurora, CO, USA

    Michael R. Dayton MD

Authors
  1. Dana L. Judd PT, DPT
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  2. Douglas A. Dennis MD
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  3. Abbey C. Thomas PhD, ATC
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  4. Pamela Wolfe MS
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  5. Michael R. Dayton MD
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  6. Jennifer E. Stevens-Lapsley PT, PhD
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Corresponding author

Correspondence to Dana L. Judd PT, DPT.

Additional information

This work was supported by NIH/NIA K23AG029978 (JS-L) and supported in part by NIH/NCATS Colorado CTSI UL1 TR000154. Additional funding was provided by the American College of Rheumatology REF/Abbot Health Professional Graduate Student Research Preceptorship Award (DJ).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

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Judd, D.L., Dennis, D.A., Thomas, A.C. et al. Muscle Strength and Functional Recovery During the First Year After THA. Clin Orthop Relat Res 472, 654–664 (2014). https://doi.org/10.1007/s11999-013-3136-y

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  • DOI: https://doi.org/10.1007/s11999-013-3136-y

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