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Surgeons Take an Extra Step to Improve Muscle Strength after Hip Replacement Surgery

Total hip replacement surgery, also called total hip arthroplasty (THA), is becoming a familiar procedure in many places around the world. There are several different ways to operate. The doctor may open the hip from the front, side, or back. Not everyone agrees on the best way to do this.

One of the most popular methods is called the posterolateral approach. In this case, the cut is made along the back (posterior) and side (lateral) of the hip. It's a simpler way to get to the hip. However, there's a risk of having the new hip dislocate with this method.

One way to prevent hip dislocation with a posterolateral approach is called posterolateral reconstruction. In this operation, the joint covering (capsule) and nearby tendons and muscles are stitched back in place. The hip is turned out slightly while the tissues are stitched up. The idea is to restore strength and stability to the joint.

Japanese doctors studied the effect of this reconstruction on hip range of motion (ROM) and muscle strength. They found that with soft tissue reconstruction, strength is greater without a loss of ROM. The group who had THA without reconstruction had equal ROM, but less strength.

The authors of this study suggest a posterolateral THA with soft tissue reconstruction. They feel that this extra step improves joint stability and muscle force without limiting joint ROM.

References: Tetsu Yamaguchi, MD, et al. The Effect of Posterolateral Reconstruction on Range of Motion and Muscle Strength in Total Hip Arthroplasty. In The Journal of Arthroplasty. April 2003. Vol. 18. No. 3. Pp. 347-351.

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