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      Effects of perioperative factors and hip geometry on hip abductor muscle strength during the first 6 months after anterolateral total hip arthroplasty

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          Abstract

          [Purpose] The importance and effect of hip joint geometry on hip abductor muscle strength are well known. In addition, other perioperative factors are also known to affect hip abductor muscle strength. This study examined the relative importance of factors affecting hip abductor muscle strength after total hip arthroplasty. [Subjects and Methods] The subjects were 97 females with osteoarthritis scheduled for primary unilateral THA. The following variables were assessed preoperatively and 2 and 6 months after surgery: isometric hip abductor strength, radiographic analysis (Crowe class, postoperative femoral offset (FO)), Frenchay Activities Index, compliance rate with home exercise, Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), and demographic data. Factors related to isometric hip abductor muscle strength 2 and 6 months after surgery were examined. [Results] Significant factors related to isometric hip abductor muscle strength at 2 and 6 months after surgery were, in extraction order: 1. isometric hip abductor muscle strength in the preoperative period; 2. BMI; and 3. the JHEQ mental score at 2 and 6 months after surgery. [Conclusion] Preoperative factors and postoperative mental status were related to postoperative isometric hip abductor strength. FO was not extracted as a significant factor related to postoperative isomeric hip abductor strength.

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          Most cited references28

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          Total hip replacement in congenital dislocation and dysplasia of the hip.

          The results of thirty-one total hip replacements in twenty-four patients with either severe congenital dysplasia or dislocation, after an average follow-up of four years, were excellent in eleven, good in sixteen, fair in one, and poor in one. The operative technique included superolateral bone grafts to increase the acetabular coverage in six hips. Twenty-seven hips required smaller and straighter femoral components than normal. The incidence of major complications was 19 per cent.
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            Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review.

            Total joint arthroplasty is a highly efficacious and cost-effective procedure for moderate to severe arthritis in the hip and knee. Although patient characteristics are considered to be important determinants of who receives total joint arthroplasty, no systematic review has addressed how they affect the outcomes of total joint arthroplasty. This study addresses how patient characteristics influence the outcomes of hip and knee arthroplasty in patients with osteoarthritis. We searched 4 bibliographic databases (MEDLINE 1980-2001, CINAHL 1982-2001, EMBASE 1980-2001, HealthStar 1998-1999) for studies involving more than 500 patients with osteoarthritis and 1 or more of the following outcomes after total joint arthroplasty: pain, physical function, postoperative complications (short-and long-term) and time to revision. Prognostic patient characteristics of interest included age, sex, race, body weight, socioeconomic status and work status. Sixty-four of 14,276 studies were eligible for inclusion and had extractable data. Younger age (variably defined) and male sex increased the risk of revision 3-fold to 5-fold for hip and knee arthroplasty. The influence of weight on the risk of revision was contradictory. Mortality was greatest in the oldest age group and among men. Function for older patients was worse after hip arthroplasty (particularly in women). Function after knee arthroplasty was worse for obese patients. Although further research is required, our findings suggest that, after total joint arthroplasty, younger age and male sex are associated with increased risk of revision, older age and male sex are associated with increased risk of mortality, older age is related to worse function (particularly among women), and age and sex do not influence the outcome of pain. Despite these findings, all subgroups derived benefit from total joint arthroplasty, suggesting that surgeons should not restrict access to these procedures based on patient characteristics. In addition, future research needs to provide standardized measures of outcomes.
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              Effect of femoral offset on range of motion and abductor muscle strength after total hip arthroplasty.

              At a minimum of one year after operation, we studied 64 patients with 86 total hip arthroplasties (THA) by standard anteroposterior hip and pelvic radiographs and measurement of range of motion and of isometric abduction strength. The femoral offset correlated positively with the range of abduction (p = 0.046). Abduction strength correlated positively with both femoral offset (p = 0.0001) and the length of the abductor lever arm (p = 0.005). Using multiple regression, abduction strength correlated with height (p = 0.017), gender (p = 0.0005), range of flexion (p = 0.047) and the abductor lever arm (p = 0.060). Our findings suggest that greater femoral offset after THA allows both an increased range of abduction and greater abductor strength.
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                Author and article information

                Journal
                J Phys Ther Sci
                J Phys Ther Sci
                JPTS
                Journal of Physical Therapy Science
                The Society of Physical Therapy Science
                0915-5287
                2187-5626
                24 February 2017
                February 2017
                : 29
                : 2
                : 295-300
                Affiliations
                [1) ] Department of Rehabilitation Medicine, Tokyo Medical and Dental University Graduate School, Japan
                [2) ] Showa University School of Nursing and Rehabilitation Sciences, Japan
                [3) ] Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University Graduate School, Japan
                [4) ] Clinical Center for Sports Medicine & Sports Dentistry, Tokyo Medical and Dental University, Japan
                [5) ] Faculty of Symbiotic Systems Science, Fukushima University, Japan
                [6) ] Shonan Kamakura Joint Reconstruction Center, Japan
                Author notes
                [* ]Corresponding author. Takashi Ikeda, Department of Rehabilitation Medicine, Tokyo Medical and Dental University Graduate School: 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan. (E-mail: ikereh@ 123456tmd.ac.jp ; tk.ikeda@ 123456nr.showa-u.ac.jp )
                Article
                jpts-2016-914
                10.1589/jpts.29.295
                5332992
                28265161
                4267cb95-cf42-41d0-8029-774f4f2ead03
                2017©by the Society of Physical Therapy Science. Published by IPEC Inc.

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd/4.0/ ).

                History
                : 19 October 2016
                : 07 November 2016
                Categories
                Original Article

                hip muscle strength,femoral offset,mental status
                hip muscle strength, femoral offset, mental status

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