Association between Hip Center Position and Isokinetic Hip Muscle Performance after Anterolateral Muscle-Sparing Total Hip Arthroplasty

Abstract

Background and objectives: The superior placement of the acetabular cup induced the delayed recovery of abductor muscle moment after total hip arthroplasty (THA) with a conventional posterior approach. The anterior-based muscle-sparing (ABMS) THA effectively reduces soft tissue damage, including muscles. The influence of hip center position on anterior-based muscle-sparing (ABMS) total hip arthroplasty (THA) for post-operative hip muscle strength was unclear. We evaluate whether the hip center position affects the recovery of hip muscle strength after ABMS THA. Materials and Methods: The study was performed as a retrospective cohort study, and included 38 hips in 38 patients that underwent primary ABMS THA. Muscle strength was measured using isokinetic dynamometry before the operation, and at 6 and 12 months after surgery. The horizontal and vertical centers of rotation (H-COR and V-COR), vertical shift (V-shift), leg length, and global femoral offset were determined radiographically in reference to a previous report. Results: A weak negative correlation was observed between abduction muscle strength at 6 months and V-shift; a V-shift more than 15 mm demonstrated significantly decreased abductor muscle strength at 6 months. Conclusions: The superior placement of the hip center caused delayed recovery of abductor muscle strength in hips with anterolateral minimally invasive THA. There seems to exist no biomechanical reason why the same should not also be the case for the muscle-sparing approach.

Impact of acetabular roof’s angle on precision of cup center of rotation reproduction and placement in total hip arthroplasty

“…Additionally, the superior placement of the hip center caused delayed recovery of abductor muscle strength in hips with anterolateral minimally invasive THA. There seems to exist no biomechanical reason why the same should not also be the case for the muscle-sparing approach [ 17 , 18 ].…”

“…Additionally, the superior placement of the hip center caused delayed recovery of abductor muscle strength in hips with anterolateral minimally invasive THA. There seems to exist no biomechanical reason why the same should not also be the case for the muscle-sparing approach [17,18]. Many research papers focus on medialization of the COR, sometimes linked with the increase in femoral offset, although the correlation between the offset and the range of motion is also under discussion [19].…”

Comparison of postoperative isokinetic quadriceps and gluteal muscular strength after primary THA: is there an early benefit through enhanced recovery programs?

“…Tanaka et al studied the influence of hip center position on abductor muscular strength with a Biodex system. They detected an association between superior placement and delayed recovery of abductor muscular strength [28]. Although total hip arthroplasty (THA) is expected to result in a postoperative loss of muscular strength, no study investigated the benefit of an ERAS concept on skeletal muscles surrounding the hip in detail.…”

Clinical Outcomes for Total Hip Arthroplasty with and without Previous Curved Periacetabular Osteotomy

“…Komiyama et al [ 19 ] recommended cup placement at the anatomic hip center, as the high decreased range of motion in THA leading to the dislocation. Furthermore, Tanaka et al [ 40 ] reported that superior placement of the hip center caused delayed recovery of abductor muscle strength after THA. In the present study, the cup placement in the osteotomy group at an equivalent position to that in the control group was one of the factors that prevented dislocation after THA.…”