title: Muscular strength after total hip arthroplasty. A prospective comparison of 3 surgical approaches.
abstract: OBJECTIVE
  Minimizing the decrease in muscular strength after total hip arthroplasty (THA) might allow patients to recover faster. We evaluated muscular strength in patients who were operated on using 3 surgical approaches. PATIENTS AND METHODs: In a prospective cohort study, 60 patients scheduled for primary THA were allocated to the direct lateral, posterior, or anterior approach. Leg press and abduction strength were evaluated 2 weeks or less preoperatively, 2 and 8 days postoperatively, and at 6-week and 3-month follow-up.
  
  
  RESULTS
  Differences in maximal strength change were greatest after 2 and 8 days. The posterior and anterior approaches produced less decrease in muscular strength than the direct lateral approach. 6 weeks postoperatively, the posterior approach produced greater increase in muscular strength than the direct lateral approach, and resulted in a greater increase in abduction strength than the anterior approach. At 3-month follow-up, no statistically significant differences between the groups were found. The operated legs were 18% weaker in leg press and 15% weaker in abduction than the unoperated legs, and the results were similar between groups.
  
  
  CONCLUSIONS
  The posterior and anterior approaches appeared to have the least negative effect on abduction and leg press muscular strength in the first postoperative week; the posterior approach had the least negative effect, even up to 6 weeks postoperatively. THA patients have reduced muscle strength in the operated leg (compared to the unoperated leg) 3 months after surgery.
authors.affiliation: a 1 Orthopaedic Research Centre, Orthopaedic Department, Trondheim University Hospital , Trondheim.|b 2 Department of Neuroscience, Norwegian University of Science and Technology , Trondheim.
authors.forename: Siri B
authors.initials: SB
authors.lastname: Winther
authors.affiliation: c 3 Faculty of Nursing, Sør-Trøndelag University College , Trondheim.
authors.forename: Vigdis S
authors.initials: VS
authors.lastname: Husby
authors.affiliation: a 1 Orthopaedic Research Centre, Orthopaedic Department, Trondheim University Hospital , Trondheim.
authors.forename: Olav A
authors.initials: OA
authors.lastname: Foss
authors.affiliation: a 1 Orthopaedic Research Centre, Orthopaedic Department, Trondheim University Hospital , Trondheim.
authors.forename: Tina S
authors.initials: TS
authors.lastname: Wik
authors.affiliation: d 4 Department of Orthopaedics, Sørlandet Hospital , Arendal.
authors.forename: Svein
authors.initials: S
authors.lastname: Svenningsen
authors.affiliation: e 5 Department of Physiotherapy, Trondheim University Hospital , Trondheim, Norway.
authors.forename: Monika
authors.initials: M
authors.lastname: Engdal
authors.affiliation: a 1 Orthopaedic Research Centre, Orthopaedic Department, Trondheim University Hospital , Trondheim.
authors.forename: Kristin
authors.initials: K
authors.lastname: Haugan
authors.affiliation: a 1 Orthopaedic Research Centre, Orthopaedic Department, Trondheim University Hospital , Trondheim.
authors.forename: Otto S
authors.initials: OS
authors.lastname: Husby
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods* / Q000534:rehabilitation; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018908:Muscle Weakness / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation; D015207:Osteoarthritis, Hip / Q000601:surgery; D010147:Pain Measurement; D056888:Patient Positioning; D011182:Postoperative Care; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome