Effect of Superior Placement of the Hip Center on Abductor Muscle Strength in Total Hip Arthroplasty

We evaluated 100 limbs in 50 patients who had undergone unilateral primary total hip arthroplasty with a normal contralateral hip. The 50 patients were divided into 2 groups by postoperative acetabular cup position, specifically by inferior and superior placement (inferior and superior groups). Hip abductor muscle strength was evaluated qualitatively by the modified Trendelenburg test and quantitatively by handheld dynamometer. The ratio of normalized strength of the reconstruction side to that of the nonoperated side was calculated (strength ratio). The modified Trendelenburg test was positive in 5 of 23 patients in the inferior group and 11 of 27 in the superior group (P < .05). The strength ratio of the superior group was decreased by 7.7% in comparison with that of the inferior group (P < .01).