Over 350,000 total hip replacements are performed in our country each year. Most commonly these surgeries are performed to improve pain and function in end stage hip osteoarthritis. In prior decades, a posterior or backside approach was common in the replacement. In comparison, an anterior or frontside approach to the hip is more common in recent years. This latter approach has been associated with reduced post operative complications and accelerated patient recoveries.
In our Boulder Physical Therapy and Lafayette Physical Therapy clinics we have found less patients are recommended to attend post operative Physical Therapy after this anterior approach. Although pain has improved these patients often demonstrate significant deviations in their gait and a loss of lower body muscle strength if they are not provided with post operative Physical Therapy. A recent long term follow up study documented the significant muscular impairments on the involved and uninvolved sides after this procedure.
Sekita and colleagues publisher their findings on the strength impairments after total hip replacement in the journal Physical Therapy (2024). Researchers followed 91 women who underwent total hip replacement and 46 age matched, asymptomatic controls. Each participant underwent strength testing both their hip flexors, extensors, and abductors, as well as, their knee extensors and flexors. These tests were performed 3, 6, and 12 months after surgery. They reported hip flexion, extension, and abduction were 85%, 84%, and 76% compared to their age matched peers at 12 months. Interestingly, similar impairments of hip extension and abduction were found on the uninvolved side. These hip impairments likely contribute to the significant gait deviations observed in patients with hip replacement.
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