Evidence map›Paper›PMID 39105846›Full record

Trial reportArchives of orthopaedic and trauma surgery2024

Favourable mid-term isokinetic strength after primary THA combined with a modified enhanced recovery after surgery concept (ERAS) in a single blinded randomized controlled trial.

Jan Reinhard, Julia Sabrina Schiegl, Stefano Pagano, Franziska Leiss, Tobias Kappenschneider, Günther Maderbacher, Joachim Grifka, Felix Greimel

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jan ReinhardDepartment of Orthopedic Surgery, University Medical Center Regensburg, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Germany. jan.reinhard@ukr.de.ORCID http://orcid.org/0000-0003-2946-2535
Julia Sabrina SchieglDepartment of Orthopedic Surgery, University Medical Center Regensburg, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Germany.
Stefano PaganoDepartment of Orthopedic Surgery, University Medical Center Regensburg, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Germany.
Franziska LeissDepartment of Orthopedic Surgery, University Medical Center Regensburg, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Germany.
Tobias KappenschneiderDepartment of Orthopedic Surgery, University Medical Center Regensburg, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Germany.
Günther MaderbacherDepartment of Orthopedic Surgery, University Medical Center Regensburg, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Germany.
Joachim GrifkaDepartment of Orthopedic Surgery, University Medical Center Regensburg, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Germany.
Felix GreimelDepartment of Orthopedic Surgery, University Medical Center Regensburg, Kaiser-Karl-V-Allee 3, 93077, Bad Abbach, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMuscular deficits as part of severe osteoarthritis of the hip may persist for up to two years following total hip arthroplasty (THA). No study has evaluated the mid-term benefit of a modified enhanced-recovery-after-surgery (ERAS) concept on muscular strength of the hip in detail thus far. We (1) investigated if a modified ERAS-concept for primary THA improves the mid-term rehabilitation of muscular strength and (2) compared the clinical outcome using validated clinical scores.

methodsIn a prospective, single-blinded, randomized controlled trial we compared patients receiving primary THA with a modified ERAS concept (n = 12, ERAS-group) and such receiving conventional THA (n = 12, non-ERAS) at three months and one year postoperatively. For assessment of isokinetic muscular strength, a Biodex-Dynamometer was used (peak-torque, total-work, power). The clinical outcome was evaluated by using clinical scores (Patient-Related-Outcome-Measures (PROMs), WOMAC-index (Western-Ontario-and-McMaster-Universities-Osteoarthritis-Index), HHS (Harris-Hip-Score) and EQ-5D-3L-score.

resultsThree-months postoperatively, isokinetic strength (peak-torque, total-work, power) and active range of motion was significantly better in the modified ERAS group. One year postoperatively, the total work for flexion was significantly higher than in the Non-ERAS group, whilst peak-torque and power did not show significant differences. Evaluation of clinical scores revealed excellent results at both time points in both groups. However, we could not detect any significant differences between both groups in respect of the clinical outcome.

conclusionWith regard to muscular strength, this study supports the implementation of an ERAS concept for primary THA. The combination with a modified ERAS concept lead to faster rehabilitation for up to one-year postoperatively, reflected by significant higher muscular strength (peak-torque, total-work, power). Possibly, because common scores are not sensitive enough, the results are not reflected in the clinical outcome. Further larger randomized controlled trials are necessary for long-term evaluation.

Indexed as

Arthroplasty, Replacement, HipMuscle StrengthOsteoarthritis, HipAgedEnhanced Recovery After SurgeryFemaleHumansMaleMiddle AgedProspective StudiesSingle-Blind MethodBiodexEarly mobilizationEnhanced recovery after surgery (ERAS)Fast track surgeryIsokinetic strength measurementMid-term outcomeTotal hip arthroplasty (THA)

Identifiers

PMID39105846
PMCPMC11417056

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.