全髋关节置换术后 12 个月内女性手术侧和非手术侧髋关节和膝关节肌肉力量的缺陷评估。

Identifying Deficits in Hip and Knee Muscle Strength on the Surgical and Nonsurgical Sides in Women up to 12 Months After Total Hip Arthroplasty.

机构信息

Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara-shi, Kanagawa, Japan.

Department of Rehabilitation, Zama General Hospital, Zama-shi, Kanagawa, Japan.

出版信息

Phys Ther. 2024 Oct 2;104(10). doi: 10.1093/ptj/pzae099.

DOI:10.1093/ptj/pzae099

PMID:39058652

Abstract

OBJECTIVE

Regaining hip and knee muscle strength is important after total hip arthroplasty (THA). However, it is unclear if muscles other than those of the operated hip also lose strength. This study aimed to identify deficits in hip and knee strength on the surgical and nonsurgical sides in female patients up to 12 months after THA.

METHODS

Participants were 91 female patients who had hip osteoarthritis and underwent unilateral THA. Forty-six community-dwelling women who were asymptomatic were selected as control participants. Patients with locomotor disorders or postsurgical complications were excluded. Maximal isometric strength of the hip flexors, extensors, and abductors and knee extensors and flexors on the surgical and nonsurgical sides were measured before THA and 3, 6, and 12 months thereafter.

RESULTS

Twelve months after THA, hip flexion, extension, and abduction strength on the surgical side were 84.6%, 83.5%, and 76.2%, respectively, of those in individuals who were asymptomatic; at the same time point, those on the nonsurgical side were 94.8%, 83.9%, and 79.4%, respectively. Knee extension strength on the surgical side was 89.3% of that in individuals who were asymptomatic. Compared to individuals who were asymptomatic, nearly all muscles showed significantly lower strength on both sides up to 6 months after THA.

CONCLUSION

At 12 months after THA, hip and knee strength on both the surgical and nonsurgical sides did not recover to the level observed in individuals who were asymptomatic. In particular, hip abductor strength on the surgical and nonsurgical sides were 76% and 79%, respectively, of that in individuals who were asymptomatic.

IMPACT

At 12 months after THA, hip and knee strength on the surgical and nonsurgical sides did not recover to the level observed in individuals who were asymptomatic, suggesting that the nonsurgical side may be inappropriate as a control to assess strength recovery on the surgical side.

摘要

目的

全髋关节置换术（THA）后恢复髋关节和膝关节肌肉力量很重要。然而，目前尚不清楚手术侧以外的肌肉是否也会丧失力量。本研究旨在确定女性患者 THA 后 12 个月内手术侧和非手术侧髋关节和膝关节力量的缺陷。

方法

参与者为 91 名患有髋关节炎并接受单侧 THA 的女性患者。选择 46 名无症状的社区居住女性作为对照参与者。排除有运动障碍或术后并发症的患者。在 THA 之前以及之后的 3、6 和 12 个月，测量手术侧和非手术侧髋关节屈肌、伸肌和外展肌以及膝关节伸肌和屈肌的最大等长力量。

结果

THA 后 12 个月，手术侧髋关节屈肌、伸肌和外展肌的力量分别为无症状个体的 84.6%、83.5%和 76.2%；与此同时，非手术侧的力量分别为 94.8%、83.9%和 79.4%。手术侧膝关节伸肌力量为无症状个体的 89.3%。与无症状个体相比，直到 THA 后 6 个月，所有肌肉在两侧的力量均明显较低。