Time course and extent of functional recovery during the first postoperative year after minimally invasive total hip arthroplasty with two different surgical approaches—a randomized controlled trial

Foucher, Kharma C.; Wimmer, Markus A.; Moisio, Kirsten C.; Hildebrand, M.; Berli, Martin; Walker, Matthew R.; Berger, Richard A.; Galante, Jorge O.

doi:10.1016/j.jbiomech.2010.10.026

Cited by 56 publications

(67 citation statements)

References 52 publications

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“…The greatest change in strength and function may occur early after surgery [21,22]; however, data quantifying acute postoperative changes are lacking. Furthermore, few studies have measured these outcomes at regular intervals during recovery [8,13,21]. Because rehabilitation is most likely to be recommended in this timeframe, information on the deficits present early after surgery is required to make informed decisions regarding rehabilitative intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Because self-report measures of function do not correlate well to performance measures of physical function [50] and may overestimate patients' true functional abilities [51], a more comprehensive evaluative strategy is needed. Moreover, although some recent investigations have examined periodic recovery after THA [8,13], other investigations have been cross-sectional or have examined only two time points after THA. Therefore, the ability to identify the time course of functional recovery for comparison to selfreported outcomes is limited [9,41,53].…”

Section: Introductionmentioning

confidence: 99%

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Muscle Strength and Functional Recovery During the First Year After THA

Judd¹,

Dennis

Thomas³

et al. 2013

Clin Orthop Relat Res

146

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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 selfreported 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).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Muscle Strength and Functional Recovery During the First Year After THA

Judd¹,

Dennis

Thomas³

et al. 2013

Clin Orthop Relat Res

146

View full text Add to dashboard Cite

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“…Specifically, stepwise multiple regression analysis suggested that the TUG test is most useful as a preoperative assessment tool for predicting the ambulation ability at an early stage after THA. It was reported that preoperative physical therapy, conducted for patients who have undergone THA, improves muscle strength and gait, allowing an early return to ambulatory function 2,3) . Therefore, the preoperative practice of exercise programs, especially those including improvement of walking ability, may be important if patients are to regain the ability to perform ADL in the early stage after THA.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have reported that the physical function before surgery and surgical technique are robust predictors of walking ability after THA and total knee arthroplasty [2][3][4][5][6] . However, few studies have sought to identify the factors associated with the recovery of walking ability during the acute postoperative period following THA.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with the Recovery of Walking Ability Following Total Hip Arthroplasty

et al. 2011

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Abstract.[Purpose] The aim of this study was to identify the factors related to the recovery of walking ability at the early stage after total hip arthroplasty (THA). [Subjects and Methods] The subjects of this study were 99 patients who had undergone unilateral THA. The hip abductor and knee extensor strengths were measured and the timed up and go (TUG) test was performed prior to THA. The number of days to achieve gait with a cane, an index of earlyphase improvement in walking after THA, was retrospectively examined.[Results] A stepwise multiple regression analysis was performed with the number of days to achieve gait with a cane as the dependent variable, and other measurements as independent variables. The preoperative physical functions correlated with the number of days to achieve gait with a cane following THA. The stepwise multiple regression analysis selected three factors (preoperative TUG test, surgical approach, and mobility at the beginning of transfer training) as the significant variables affecting the number of days to achieve gait with a cane following THA.[Conclusion] The results of the present study suggest that preoperative TUG, surgical approach and mobility at the start of transfer training are useful indicators for predicting ambulation ability in the early stage after THA.

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“…2,3 Numerous studies have proven that gait analysis enables objective measurement of subject-specific differences following THR and to determine the functional outcome. [4][5][6][7][8] However, these studies mainly focus on kinematics and temporospatial parameters as well as the measurement of ground reaction forces. Hip reaction forces cannot be measured, however, these are important because detailed knowledge about the in-vivo load case of the hip can be used, not only for further implant improvement, but also as a measure for the post-operative outcome after an operation.…”

Section: Introductionmentioning

confidence: 99%

Measuring functional outcome after total hip replacement with subject-specific hip joint loading

Weber

Dendorfer

Dullien

et al. 2012

Proc Inst Mech Eng H

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Total hip replacement is an often-performed orthopedic surgical procedure; the amount of procedures undertaken will increase since our life expectancy is growing. In order to optimize function, hip biomechanics should be restored to as near normal as possible. The goal of this pilot study was to determine whether or not it is feasible to compute the vectorial hip reaction force pathways on the head of the prosthesis and the force angles relative to the cup of the prosthesis that occur during gait in total hip replacement patients, serving as an objective measurement of the functional outcome following hip replacement.A three-dimensional gait analysis, measuring ground reaction forces and kinematics, was performed. The data retrieved from the gait analysis was used as the input for the musculoskeletal model to compute vectorial joint reaction forces for data processing. To evaluate the position and orientation of the joint reaction forces, the force path, as well as the force angles for the operated and non-operated joint, has been calculated during the stance phase of the specific leg.The force path for subject 2 on the non-operated side is only located in the posterior-lateral quarter, as is the force path for subject 1. In contrast to this subject, the force path for subject 2 at the operated hip joint can be found only within the anterior quarter of the head of the implant, where it is nearly equally distributed in the medio-lateral half of the prosthesis head. The force-inclination angles on the cup of subject 1, with respect to the plane of the socket face, indicates that the force vector is mainly positioned in the same quadrant when compared with subject 2 (in a cup-fixed coordinate system). The force-anteversion angle behaves similarly to the force-inclination angle, even when the effects are not as pronounced.The proposed methods in this article are aiming to define two functional outcomes of total hip replacement that are related to wear and rim loading. It is accepted that wear is not only a function of time, but a function of use. Owing to the methods listed in this article, we are able to determine a) the applied force and b) the sliding distance (force pathway) in a subject-specific manner. The computed hip-reaction force angles and the distance to the rim cup are a measurement for cup or rim loading, and occurs in the so-called safe-zones. This method may well give us insight into the biomechanical situation during gait, after receiving total hip replacement, that we need to fully understand the mechanisms acting on a hip joint and to prove a possible increase of functional outcome after receiving total hip replacement.

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Time course and extent of functional recovery during the first postoperative year after minimally invasive total hip arthroplasty with two different surgical approaches—a randomized controlled trial

Cited by 56 publications

References 52 publications

Muscle Strength and Functional Recovery During the First Year After THA

Muscle Strength and Functional Recovery During the First Year After THA

Factors Associated with the Recovery of Walking Ability Following Total Hip Arthroplasty

Measuring functional outcome after total hip replacement with subject-specific hip joint loading

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