Impairment of muscle performance before and following total hip replacement

The aim of this preliminary descriptive study was to investigate the presurgical condition and medium term postsurgical outcomes of pain, function and muscle performance in patients with total hip replacements who do not receive specific perioperative exercise. The 17 participants in this within-subject study were acute tertiary hospital patients scheduled for total hip replacement. The main outcome measures were pain visual analogue scale), function (timed up and go test and stair climbing), and muscle performance (isokinetic testing of quadriceps and hamstrings). These measures were collected by a physiotherapist blinded to the purpose of the study, at three time periods, twice before surgery to establish stability of measurement and at 8-12 weeks post surgery. Following total hip replacement pain decreased and function generally improved. Concentric and eccentric performance of the tested muscles on the operated side returned to the preoperative state, but remained significantly weaker than the unoperated side 8-12 weeks following surgery. Poor muscle performance was correlated with poor function indicating that appropriate and targeted strengthening exercises to the muscles controlling the knee and hip joints on the operated side may be required to achieve maximum functional outcome.