Many studies striving to achieve better outcomes for
TKA patients continue to focus on impairments associated
directly with the knee joint. Recovery has been variable
and the majority of patients continue to demonstrate
lower extremity muscle weakness and functional deficits
such as slower walking speeds, difficulty negotiating stairs
and difficulty rising from a chair when compared to agematched
healthy individuals [13, 60, 82–84]. Therefore, it
is reasonable to hypothesize that the causes of disability
and poor function following TKA may also be related to
other joints, particularly the hip. This hypothesis is further
strengthened by the presence of hip abductor muscle
weakness in patients with knee OA [14] which persists
post TKA [20]. Patients with greater lower limb strength
following TKA perform better on functional activities [83]
demonstrating that lower limb strength contributes to
functional performance. Investigations into the role of
hip abductor strength following TKA have showed significant
contributions of hip strength to function [21].
This is not surprising given that hip strength and hip
joint mechanics have a close relationship to normal
knee function. Achieving optimal outcomes following
TKA therefore would require optimal hip strength in
combination with optimal quadriceps strength. The investigation
into targeted hip strengthening is warranted
in this patient group.