Could the Evaluation of Muscle Strength Imbalances Be Used as a Predictor of Total Hip Arthroplasty?

Abstract

Loss of muscle strength characterizes the period before total hip arthroplasty (THA). Little is known about whether muscle strength imbalances caused by muscle strength decline could be considered another clinical predictor for THA. This study aimed to determine whether muscle imbalances may be used as a clinical predictor for THA surgery. Thirty-six participants were enrolled in the study. Eighteen patients had THA (THA group), while 18 were healthy elders (CON group). Ipsilateral (H/Q) and bilateral (% Def) muscle imbalances of the knee were assessed. THA patients showed impairment of the extensors on the affected extremity compared to those unaffected. A comparison between the groups proved there were weakened flexors in the THA group on both extremities. A comparison of the imbalances revealed a significant bilateral imbalance of the extensors and ipsilateral imbalance of both extremities in the THA group. We computed two logistic regressions using bilateral and ipsilateral imbalance as the predictors of THA surgery. We found that bilateral extensor imbalance may be used as a predictor for THA (Nagelkerke R2 = 0.22). A decrease of the bilateral extensors imbalance by 8% decreases the probability of THA by 8%. The most interesting finding is that the evaluation of the bilateral extensor imbalance may be used as another clinical predictor for THA.

Patients Undergoing Hip or Knee Arthroplasty in Poland Based on National Data—Challenge for Healthcare in Aging Society

“…Vodička et al seems to provide further arguments pointing to deficits in flexors and extensors as predictors of arthroplasty. In their study, an imbalance reduced by 8% decreases the probability of THA by the same percentage value [27]. Therefore, data obtained in other studies indicate a beneficial effect of preoperative rehabilitation on the reduction in the risk of the need to perform the procedure itself with an adequately early response or reduction in the hospitalization period, its costs, and faster return to daily activity.…”

“…In order to reduce the risk of postoperative complications, the employment of not only pre-operative rehabilitation, in the sense of improving the overall fitness and development of muscle strength [27], is advisable but also, e.g., psychological health and social functioning should be worked on [28,29].…”

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

“…The study supports the use of an ERAS concept for primary THA, featuring early mobilization, local infiltration analgesia and intense postoperative physiotherapy. It is known that osteoarthritis of the hip leads to a loss of muscular strength of the affected side, accompanied by reduced muscular density [21, 24, 33]. Additionally, patients in need of primary THA represent a rather old cohort.…”

Functional Ipsilateral and Bilateral Strength Ratios in Young Elite Athletes Across Multiple Sports Disciplines

“…The assessment of peak torque (PT) was conducted using an isokinetic dynamometer (Humac NORM, Computer Sports Medicine, Stoughton, MA, USA), a validated instrument known for its reliability in quantitatively evaluating muscular performance (Shahtahmassebi et al, 2017;Vodička et al, 2021;Zore et al, 2021). In terms of anthropometric measurements, a digital scale (Tanita WB 150 MA, TANITA Corporation, Tokyo, Japan) was employed to determine body mass, while a mobile stadiometer (Seca 214 ® , Seca, Hamburg, Germany) was used for height measurement.…”