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Effect of preoperative limb-length discrepancy on abductor strength after total hip arthroplasty in patients with developmental dysplasia of the hip

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Limb-length discrepancy (LLD) arising from hip subluxation or dislocation and accompanied by insufficiency of hip abductor in patients with developmental dysplasia of the hip (DDH) can be corrected partially or completely with total hip arthroplasty (THA). However, information about post-THA changes in abductor strength related to preoperative LLD in patients with DDH is lacking. We aimed to explore the post-THA recovery course of abductor muscle strength and its related factors in patients with DDH.

Methods

A cohort of 45 patients with unilateral DDH was divided into two groups according to their Crowe classification: patients with class I or II DDH formed Group M, and patients in class III and IV DDH formed Group S. The following parameters were measured on standardized antero-posterior hip radiographs taken in the supine position pre- and post-THA: abductor muscle length, abductor lever arm, LLD, and femoral offset (FO). Abductor strength was evaluated quantitatively with the Isomed 2000 isokinetic test system (1 week before the operation and 1, 3, 6, and 12 months after the operation). The contralateral normal hip joint served as a within-patient control. The affected side:healthy side ratios of the parameters above were calculated.

Results

Abductor strength ratio evaluated at the five follow-up time points was larger in Group M than that in Group S (p < 0.001). The average abductor strength ratio reached 78.5, 85.4, and 89.2 % at the 3, 6, and 12 months postoperative exams, respectively, in Group M, and reached 50.3, 63.2, and 72.9 % in Group S. The abductor muscle length ratio, the abductor muscle level arm ratio, and the FO ratio were significantly increased postoperatively, relative to preoperative assessment, in the two groups. LLD was reduced significantly postoperatively, relative to preoperative values, in both groups. Both preoperative LLD (r = −0.791, p < 0.001) and the change in abductor muscle length ratio (r = −0.659, p < 0.001) correlated with abductor strength recovery.

Conclusion

Patients showed the greatest improvement in abductor strength within the first 6 months after THA, especially during the first 3 months. Abductor strength was consistently greater in patients with mild dysplasia than in patients with severe dysplasia. The extent of preoperative LLD and the increase in abductor length were related with post-THA abductor strength recovery in patients with DDH.

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Acknowledgments

We thank Mr. Xiaosheng Li, the technician from Xi’an Physic Education University for his assistance with the measurement of the abductor strength. The study was supported by Fundamental Research Funds for the Central Universities (No. XJJ20100207) and the National Natural Science Foundation (No. 81101337).

Conflict of interest

The authors have no competing interests to declare.

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Authors and Affiliations

  1. Department of Orthopaedic, The Second Hospital Affiliated to Medical College, Xi’an Jiaotong University, No. 157, Xiwu Road, Xi’an, Shaanxi, 710004, People’s Republic of China

    Ruiyu Liu, Yongwei Li, Chuanyi Bai, Qichun Song & Kunzheng Wang

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  1. Ruiyu Liu
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  2. Yongwei Li
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  3. Chuanyi Bai
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Correspondence to Kunzheng Wang.

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Liu, R., Li, Y., Bai, C. et al. Effect of preoperative limb-length discrepancy on abductor strength after total hip arthroplasty in patients with developmental dysplasia of the hip. Arch Orthop Trauma Surg 134, 113–119 (2014). https://doi.org/10.1007/s00402-013-1899-y

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  • DOI: https://doi.org/10.1007/s00402-013-1899-y

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