Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland.
Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland; Department of Orthopaedic Surgery and Traumatology, Bruderholz, Switzerland.
J Arthroplasty. 2021 Aug;36(8):3015-3027. doi: 10.1016/j.arth.2021.03.042. Epub 2021 Mar 25.
The aims of this study were to assess and quantify hip abductor muscle strength deficits after total hip arthroplasty (THA) and to determine associations with external factors.
Studies reporting on hip abductor muscle strength before and/or after THA performed for osteoarthritis or atraumatic osteonecrosis of the hip were considered for inclusion. Data sources were Embase, Medline, and the Cochrane Central Register of Controlled Trials. Muscle strength on the affected side was compared with the healthy contralateral side or with control subjects. Study quality was assessed using a modified Newcastle-Ottawa Scale.
Nineteen studies reporting on 875 subjects met the inclusion criteria. Patients scheduled for THA had a mean strength deficit of 18.6% (95% confidence interval (CI) [-33.9, -3.2%]) compared with control subjects. Abductor muscle strength then increased by 20.2% (CI [5.6, 34.8%]) at 4-6 months, 29.6% (CI [4.7, 54.4%]) at 9-12 months, and 49.8% (CI [-31.0, 130.6%]) at 18-24 months postoperatively compared with preoperative values. For unilateral THA, the mean torque ratio was 86.3% (CI [75.4, 97.2%]) and 93.4% (CI [75.1, 111.6%]) before and >24 months after THA, respectively. Study quality was low to moderate.
Hip abductor muscle strength deficits may gradually improve during 24 months after THA possibly without complete recovery. Cautious interpretation of these findings is warranted because high-quality evidence is largely missing.
本研究旨在评估和量化全髋关节置换术（THA）后髋关节外展肌肌力的缺陷，并确定与外部因素的关联。
纳入了报告髋关节外展肌肌力在 THA 术前和/或术后的研究，这些 THA 是由于骨关节炎或非创伤性股骨头坏死而进行的。数据来源为 Embase、Medline 和 Cochrane 对照试验中心注册库。患侧的肌肉力量与健侧或对照组进行比较。使用改良的 Newcastle-Ottawa 量表评估研究质量。
有 19 项研究报告了 875 名受试者，符合纳入标准。与对照组相比，计划接受 THA 的患者的平均肌力缺陷为 18.6%（95%置信区间[-33.9，-3.2%]）。术后 4-6 个月，外展肌肌力增加 20.2%（CI [5.6，34.8%]），9-12 个月增加 29.6%（CI [4.7，54.4%]），18-24 个月增加 49.8%（CI [-31.0，130.6%]）。对于单侧 THA，平均扭矩比分别为术前的 86.3%（CI [75.4，97.2%]）和术后 >24 个月的 93.4%（CI [75.1，111.6%]）。研究质量为低至中度。
THA 后 24 个月内，髋关节外展肌肌力缺陷可能逐渐改善，但可能无法完全恢复。由于缺乏高质量证据，需要谨慎解释这些发现。
