Effectiveness of Hip Abductors Strengthening in Patients with Total Knee Arthroplasty: A Randomized Control Trial

Introduction: Total Knee Arthroplasty (TKA) is a widely performed surgery for end-stage knee osteoarthritis, but many patients continue to experience pain and functional limitations postoperatively. While rehabilitation traditionally emphasizes quadriceps and hamstring strengthening, growing evidence highlights the critical role of hip abductors in enhancing lower limb function and stability. This study aims to compare the effectiveness of adding hip abductor strengthening to quadriceps/hamstrings exercises versus quadriceps/hamstrings exercises strengthening alone on pain, symptoms, QoL, ADLs and functional outcomes in TKA patients. Material and Methods: The study was randomized controlled trial (RCT)in nature involved 20 subjects, aged between 50 and 70 years who had undergone unilateral Total Knee Arthroplasty (TKA) for primary osteoarthritis were included. The patients were randomly divided into two equal groups. Group A (n= 10) and Group B (n=10). Further the patients were assessed for Pain, symptoms, quality of life and activities of daily life by KOOS (Knee injury and Osteoarthritis Outcome Score) and lower extremity functions were assessed by LEFS (Lower Extremity Functional Scale). Group A (experimental group) received Hip abductors strengthening along with quadriceps/hamstrings strengthening and Group B (control group) received only quadriceps/hamstrings strengthening. The intervention consisted of 5 sessions per week for 12 weeks. Patients were assessed at 0th week and reassessed at the end of 12th week after completing the treatment. Result: Statistical analysis revealed significant improvement within both groups. However, between-group comparison demonstrated that Group A exhibited statistically significant improvement (p < 0.05) than Group B across all outcome measures, including KOOS and LEFS. Conclusion: The study concluded that adding hip abductor strengthening to quadriceps/hamstrings rehabilitation leads to greater improvements in pain, symptoms, quality of life, daily activities and lower limb function in patients who have undergone total knee Arthroplasty (TKA). Key words: Hip abductors strengthening, Quality of Life, Total knee Arthroplasty