Article

Changes in knee-extension strength and functional-performance at discharge after fast-track total hip arthroplasty (THA)
and (2) investigate whether these changes correlate to changes in thigh and knee
circumference (ie, swelling) or pain. DESIGN: A prospective, descriptive,
hypothesis-generating study. SETTING: A special unit for fast-track hip and knee
arthroplasty operations at a university hospital. PARTICIPANTS: Twenty-four
patients (20 women and 4 men; ages 69 +/- 6.1 years) scheduled for primary
unilateral THA. METHODS:
All patients were evaluated before surgery and on the
day of hospital discharge. MAIN OUTCOME MEASURES: Knee-extension strength, thigh
and knee joint circumference, hip pain, and functional performance (Timed Up &
Go, 30-Second Chair Stand, and 10-Meter Walk tests). RESULTS: All investigated
variables changed significantly from before to after surgery, except for hip
pain. The average loss in knee-extension strength after surgery (32%, P = .01)
did not correlate with increased thigh circumference (6%, P < .01) or knee
circumference (3%, P < .01) or with reductions in functional performance: Timed
Up & Go test (114%, P = .01), 30-Second Chair Stand test (36%, P = .01), and
10-Meter Walk test (50%, P < .01). Only the increase in knee circumference
correlated significantly with reduced performance in the 10-Meter Walk test time
(R = -0.59, P < .01), explaining 34% of the variance in the 10-Meter Walk test.
No correlations between changes in hip pain and functional performance or
knee-extension strength were found. Mean postoperative hospital stay was 2.1
days. CONCLUSIONS: Knee-extension strength is considerably reduced at discharge
after THA, but the early strength reduction does not correlate with changes in
thigh or knee circumferences. Because functional performance is also considerably
reduced at discharge (unrelated to reduced knee-extension strength), other
mechanisms such as fear, avoidance of movement, or decreased hip-muscle strength
also may be involved.
CI - Copyright (c) 2011 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.
- Cuisse - Genou

Langue : ANGLAIS