title: Muscle strength, gait, and balance in 20 patients with hip osteoarthritis followed for 2 years after THA.
abstract: BACKGROUND
  Patients with hip osteoarthritis (OA) have muscular weakness, impaired balance, and limp. Deficits in the different limb muscles and their recovery courses are largely unknown, however. We hypothesized that there is persisting muscular weakness in lower limb muscles and an impaired balance and gait 2 years after THA.
  
  
  METHODS
  20 elderly patients with unilateral OA were assessed before, and 6 and 24 months after surgery for maximal voluntary isometric strength of hip and knee muscles and by gait analysis, postural stability, and clinical scores (HHS, SF-36, EuroQoL).
  
  
  RESULTS
  Hip muscles showed a remaining 6% weakness compared to the contralateral healthy limb 2 years after THA. Preoperatively and 6 months postoperatively, that deficit was 18% and 12%, respectively. Knee extensors fully recovered a preoperative 27% deficit after 2 years. Gait analysis demonstrated a shorter single stance phase for the OA limb compared to healthy limb preoperatively, that had already recovered at the 6-month follow-up. Balance of two-foot standing showed improvement in both sagittal and lateral sway after operation. All clinical scores improved.
  
  
  CONCLUSIONS
  Muscle strength data demonstrated a slow but full recovery of muscles acting about the knee, but there was still a deficit in hip muscle strength 2 years after THA. Gait and balance recovered after the operation. To accelerate improvement in muscular strength after THA, postoperative training should probably be more intense and target hip abductors.
authors.affiliation: Stockholm Spine Center, Löwenströmska Hospital, Upplands Väsby, Sweden. anton.rasch@spinecenter.se
authors.forename: Anton
authors.initials: A
authors.lastname: Rasch
authors.forename: Nils
authors.initials: N
authors.lastname: Dalén
authors.forename: Hans E
authors.initials: HE
authors.lastname: Berg
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D018908:Muscle Weakness / Q000209:etiology; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000601:surgery*; D004856:Postural Balance / Q000502:physiology; D011474:Prosthesis Design; D020127:Recovery of Function; D013997:Time Factors