Preoperative grip strength measurement and duration of hospital stay in patients undergoing total hip and knee arthroplasty



This study explored whether a relationship exists between preoperative pinch and power grip strength, and length of hospital stay in patients undergoing hip and knee arthroplasty at a busy UK hospital. We investigated whether handgrip dynamometry could be used preoperatively to identify patients at greater risk of longer inpatient stays. This would allow focussed intervention preoperatively and facilitate predictors of length of stay postoperatively.


One hundred and sixty-four patients (64 male, 100 female) undergoing lower limb arthroplasty (83 total knee replacement, 81 total hip replacement) were assessed in pre-admission clinic. Average measurements of pinch grip, power grip and grip endurance were taken from each patient using the Jamar hydraulic dynamometer (Jamar, USA). Duration of inpatient stay of each patient was recorded.


Average duration of hospital stay was 9.4 days. Both average pinch grip strength and average power grip strength had a significant negative correlation with duration of inpatient stay. Those patients with a pinch grip strength less than 6.3 kg remained an inpatient for an average of 2 days longer than those with a pinch grip greater than 6.3 kg.


This simple test may be highly beneficial preoperatively in identifying those patients likely to require longer inpatient stays and therefore those who would benefit from early nutritional intervention and focussed physiotherapy. It may also facilitate predictors of length of stay postoperatively. We believe this may effect significant cost reductions in the NHS.

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Conflict of interest

The authors declare they have no conflict of interest. All authors have approved the manuscript and are fully conversant with its contents. No author has any potential or actual personal, financial or political interest in the material. An abstract of the work has not previously been published nor have any papers using the same data set or relating to the same topic been published or submitted by any of the authors for consideration elsewhere. There is no patient identifiable information included in the manuscript.

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Correspondence to N. Beresford-Cleary.

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Shyam Kumar, A.J., Beresford-Cleary, N., Kumar, P. et al. Preoperative grip strength measurement and duration of hospital stay in patients undergoing total hip and knee arthroplasty. Eur J Orthop Surg Traumatol 23, 553–556 (2013).

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  • Hand strength
  • Nutritional status
  • Length of stay
  • Arthroplasty