Hodnocení svalové síly pacientů indikovaných k totální endoprotéze kyčelního kloubu anterolaterálním přístupem podle Watson Jonese – prospektivní studie
| Title in English | Evalution of the muscular strenght of patients indicated for total hip arthrosplasty by Watson Jones anterolateral approach – prospective study |
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| Authors | |
| Year of publication | 2019 |
| Type | Article in Periodical |
| Magazine / Source | Dermatologie pro praktické lékaře |
| MU Faculty or unit | |
| Citation | |
| Web | https://www.casopisortopedie.cz/rok-2019/1-2019/hodnoceni-svalove-sily-pacientu-indikovanych-k-totalni-endoproteze-kycelniho-kloubu-anterolateralnim-pristupem-podle-watson-jonese-prospektivni-studie-evalution-of-the-muscular-strenght-of/ |
| Keywords | isokinetic dynamometry; muscle strength; total hip replacement; rehabilitation |
| Description | Introduction: The aim of this study is to assess the strength of the muscles of the hip and knee before and after total hip arthroplasty in patients operated on using the Watson Jones anterolateral approach. The study also evaluates the uninvolved side. Materials and Methods: The research sample of individuals indicated for total hip arthroplasty at I. Orthopedic department of St. Anne´s University Hospital in Brno was examined using isometric dynamometry. Testing for each person was performed three times (30 days before surgery, 90 days and 180 days after surgery). The bilateral concentric force of the extensors and knee flexors and the bilateral force of the extensors and flexors of the hip were diagnosed by a calibrated isokinetic dynamometer Humac Norm (CSMI, Stoughton, MA, USA). The results of the muscle strength were measured as the maximum force moment (FM) in Newton meters (Nm). The statistically significant differences in the strength in the monitored periods were subsequently verified using the Scheffe post hoc test. Results: In the case of extensors and flexors of the knee operated as well as extensors and flexors of the uninvolved limb, statistically significant differences of force were not proved. The muscular force of the hip joint extension of the hip joint showed statistically significant differences in strength in the observed periods (pre-operative and 6m after surgery, p = 0.012) and in the case of (3m after surgery and 6m after surgery, p = 0.008). For hip flexors of the operated limbs, statistically significant changes in the force difference (preoperative and 6m after surgery, p = 0.039) were demonstrated. Extensors and hip flexors of uninvolved les did not show statistically significant changes in strength. Discussion: By studying literature, we concluded, that there is no difference in muscle strength among the surgical approaches. Most of the authors confirm the improvement in flexion and extension of the hip joint after THA after 6 months. An early improvement in muscle function after 3 months compared to the preoperative status has not been proven in our study, even though most authors state it. Conclusion: Flexion and extension of the hip 6 months after THA surgery can be improved by controlled rehabilitation after Watson Jones´ anterolateral approach to the hip joint. Improvements in the function of flexors and knee extension after implantation of TEP of the hip after 6 months were not statistically proven. The muscular strength of the flexors and extensions of the uninvolved side remained unchanged. The pilot results of the study confirm the need to intensify the rehabilitation in early phase after the surgery especially focusing on the knee muscles and to motivate patients to increase physical activity even 6 months after surgery. |
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