Abstract
About 33% patients with osteoarthritis undergoing total hip/knee arthroplasty are not satisfied with the outcome, warranting the need to improve patient selection. Handgrip strength (HGS) has been suggested as a proxy for overall muscle strength and may be associated with post-arthroplasty function. This study aims to assess the association of pre-operative HGS with change in hip/knee function and quality of life in patients with arthroplasty. 226 hip (THA) and 246 knee (TKA) arthroplasty patients were included in this prospective cohort study. Pre-operative HGS was assessed by means of a dynamometer and the HOOS/KOOS and SF-36 questionnaires were collected before arthroplasty and 1 year thereafter. The association of HGS with score change on each sub-domain of the included questionnaires was assessed by linear regression models, adjusting for sex, body mass index and baseline score. Mean pre-operative HGS was 26 kg for patients undergoing THA and 24 kg for those undergoing TKA. HGS was positively associated with an increased improvement score on “function in sport and recreation”-domain in hip (β = 0.68, P = 0.005) and knee (β = 0.52, P = 0.049) and “symptoms”-domain in hip (β = 0.56, P = 0.001). For patients with THA, HGS was associated with the “quality of life” domain (β = 0.33, P = 0.033). In patients with TKA, HGS was associated with the physical component score (β = 0.31, P = 0.001). All statistically significant effects were positive, indicating that with greater pre-operative HGS, an increased gain in 1-year post-surgery score was observed. HGS can be used as a tool to inform patients with OA who are future candidates for a prosthesis about the possible improvements of certain aspects of life after arthroplasty.
Highlights
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are effective procedures to improve pain and functioning in patients with osteoarthritis (OA) [1, 2]
Kumar et al [29] demonstrated in patients with THA and TKA that a lower Handgrip strength (HGS) is associated with increased length of hospital stay while correcting for age
Difference was calculated by means of Chi-square or unpaired Student’s T test, as appropriate in age, gender and body mass index (BMI) between those who did and did not complete follow-up. Among those who completed the questionnaire, patients with TKA were significantly more often female than those who underwent THA (P = 0.001) and had a higher BMI (P < 0.001), and there was no significant difference in age between patients with THA or TKA (P = 0.605)
Summary
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are effective procedures to improve pain and functioning in patients with osteoarthritis (OA) [1, 2]. HGS has been demonstrated to associate with worse general health in the elderly as well as being a predictor for all-cause mortality in the elderly [12,13,14,15,16,17,18]. HGS has been shown to be associated with disability, malnutrition and surgery complications [19,20,21,22,23,24,25,26,27,28]. Kumar et al [29] demonstrated in patients with THA and TKA that a lower HGS is associated with increased length of hospital stay while correcting for age. The value of HGS as a predictor for long-term outcomes on other aspects of life after lower limb arthroplasty surgery are currently unknown
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