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Recovery of muscle strength and power after limb-lengthening surgery
Karen L Barker1, Sallie E Lamb, Hamish R W Simpson
1Physiotherapy Research Unit, Nuffield Orthopaedic Centre National Health Service Trust, Oxford. Karen.barker@noc.nhs.uk
Objective:
To report muscle strength, power, and function after limb-lengthening surgery performed by using the Ilizarov technique.
Design:
Prospective, longitudinal observational study of a cohort of consecutive patients who underwent limb-lengthening distraction followed up for 2 years after surgery.
Setting:
National Health Service hospital specializing in orthopedic surgery.
Participants:
Patients (N=16) who had undergone limb-lengthening surgery performed by using the Ilizarov method (11 men, 5 women; mean age=27 y; range, 13-56 y).
Interventions:
None.
Main Outcome Measures:
Muscle strength and power were assessed by using 2 validated measures: isokinetic concentric strength of the quadriceps and hamstrings measured by using a dynamometer and leg extensor power. Measures were recorded preoperatively and at 6, 12, and 24 months after the completion of lengthening. Function was measured by 2 timed tests of functional performance: stair climbing and sit-to-stand.
Results:
Overall results were good with high reports of function and satisfactory clinical examination. Both concentric muscle strength and leg power showed a clear pattern of decreased muscle strength at 6 months after frame removal, improving throughout the study period until it was within 3% of the preoperative value at 2 years. By 2 years, self-reported function and ability to complete timed functional tests had returned to or improved on the preoperative values. Muscle strength remained slightly below the preoperative value; this was more pronounced in the quadriceps than the hamstrings. There was no association between muscle strength and the amount of lengthening that had been undertaken.
Conclusions:
This study suggests that there is a small residual decrease in muscle strength and power after limb-lengthening surgery but that these do not adversely impact on a patients' ability to perform everyday functional activities.
