title: Preoperative grip strength measurement and duration of hospital stay in patients undergoing total hip and knee arthroplasty.
abstract: OBJECTIVE
  This study explored whether a relationship exists between preoperative pinch and power grip strength, and length of hospital stay in patients undergoing hip and knee arthroplasty at a busy UK hospital. We investigated whether handgrip dynamometry could be used preoperatively to identify patients at greater risk of longer inpatient stays. This would allow focussed intervention preoperatively and facilitate predictors of length of stay postoperatively.
  
  
  METHODS
  One hundred and sixty-four patients (64 male, 100 female) undergoing lower limb arthroplasty (83 total knee replacement, 81 total hip replacement) were assessed in pre-admission clinic. Average measurements of pinch grip, power grip and grip endurance were taken from each patient using the Jamar hydraulic dynamometer (Jamar, USA). Duration of inpatient stay of each patient was recorded.
  
  
  RESULTS
  Average duration of hospital stay was 9.4 days. Both average pinch grip strength and average power grip strength had a significant negative correlation with duration of inpatient stay. Those patients with a pinch grip strength less than 6.3 kg remained an inpatient for an average of 2 days longer than those with a pinch grip greater than 6.3 kg.
  
  
  CONCLUSIONS
  This simple test may be highly beneficial preoperatively in identifying those patients likely to require longer inpatient stays and therefore those who would benefit from early nutritional intervention and focussed physiotherapy. It may also facilitate predictors of length of stay postoperatively. We believe this may effect significant cost reductions in the NHS.
authors: Department of Orthopaedic Surgery, Royal Lancaster Infirmary, Ashton Road, Lancaster, Lancashire, LA1 4RP, UK. Shyam.Kumar@mbht.nhs.uk
authors: A J
authors: AJ
authors: Shyam Kumar
authors: N
authors: N
authors: Beresford-Cleary
authors: P
authors: P
authors: Kumar
authors: A
authors: A
authors: Barai
authors: N
authors: N
authors: Vasukutty
authors: S
authors: S
authors: Yasin
authors: A
authors: A
authors: Sinha
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D008297:Male; D008875:Middle Aged; D053581:Muscle Strength Dynamometer; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome