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Scott Cheatham, Monique Mokha and Matt Lee


Hip-resurfacing arthroplasty (HRA) has become a popular procedure in the treatment of hip-joint arthritis in individuals under the age of 65 y. Although the body of literature examining operative procedures has grown, there is a lack of consistent reporting of the effectiveness of an HRA postoperative rehabilitation program. To date, no systematic reviews have evaluated the available evidence on postoperative rehabilitation programs.


To evaluate the available evidence on postoperative rehabilitation programs after HRA.

Evidence Acquisition:

A systematic review was conducted according to the PRISMA guidelines. A search of PubMed, CINAHL, SPORTDiscus, ProQuest, and Google Scholar was conducted in April 2014 using the following keywords alone and in combination: postoperative, postsurgical, rehabilitation, physical therapy, programs, hip resurfacing, arthroplasty, and metal-on-metal. The grading of studies was conducted using the PEDro and Oxford Centre for Evidence-Based Medicine scales.

Evidence Synthesis:

The authors identified 648 citations, 4 of which met the inclusion criteria. The qualifying studies yielded 1 randomized control trial, 2 case reports, and 1 case series, for a total of 90 patients. Patients were mostly male (n = 86), had a mean age of 48 ± 5.47 y, and had been physically active before HRA. Postoperative rehabilitation programs varied in length (range 8–24 wk) and consisted of at least 3 phases. The methodology to assess program effects varied, but all 4 studies did measure a combination of function, pain, and quality of life using written questionnaires, with follow-up ranging from 9 mo to 1 y. The most common questionnaire was the Harris Hip Score.


This review found postoperative rehabilitation programs after HRA to be underinvestigated. Limited results indicate that postoperative rehabilitation programs may be effective in improving gait (stride length, velocity, and cadence), hip range of motion, and pain and function, as measured by questionnaires, but not hip strength.

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Maria Grazia Benedetti, Lisa Berti, Antonio Frizziero, Donata Ferrarese and Sandro Giannini


Surface replacement of the hip is aimed especially at active patients, and it seems to achieve optimal functional results in a short time if associated with a tailored rehabilitation protocol.


To assess the functional outcome in a group of active patients after hip resurfacing.


Clinical measurement and controlled laboratory study in a case series.


Gait-analysis laboratory.


8 patients and a control group of 10 subjects.


Patients treated with Birmingham hip-resurfacing system and a tailored rehabilitation protocol

Main Outcome Measures:

Clinical assessment (Harris Hip Score [HHS]) and instrumented gait analysis including muscular electromyographic assessment. Patients were assessed preoperatively and at 3 and 9 mo follow-up after surgery.


HHS showed a significant increase from the baseline to 3- (P = .008) and 9-month (P = .014) follow-up; 5 patients returned to sport. Gait pattern in the presented case series of patients improved substantially 3 mo postoperatively, and minimal further changes were present 9 months postoperatively. Residual abnormalities of time-distance and hip-kinematics parameters were consistent with a slow gait. A complete restoration of the muscle-activation pattern during gait was achieved.


Hip resurfacing associated with a rehabilitation protocol based on the characteristics of the implant provides excellent clinical and functional outcome, especially for very active patients.

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Kajetan J. Słomka, Slobodan Jaric, Grzegorz Sobota, Ryszard Litkowycz, Tomasz Skowronek, Marian Rzepko and Grzegorz Juras

capacities of the neuromuscular system to provide outcomes at the instructed intensities when performing tests of motor tasks ( Birmingham, Kramer, Speechley, Chesworth, & Macdermid, 1998 ; Robinson & Dannecker, 2004 ). However, reduced effort does not necessarily provide proportional decreases in most of

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Rafael F. Escamilla, Jonathan S. Slowik, Alek Z. Diffendaffer and Glenn S. Fleisig

approved by the institutional review board at St. Vincent’s Health System (Birmingham, AL). A retrospective review of the pitching biomechanics database at the American Sports Medicine Institute (Birmingham, AL) was performed for data collected from male professional pitchers between 2013 and 2017

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Hiroaki Hobara, Sakiko Saito, Satoru Hashizume, Hiroyuki Sakata and Yoshiyuki Kobayashi

Athletics Grand Prix Final, Birmingham 2014 2 Great City Games Manchester 2014 1 Sainsbury’s Anniversary Games 2013 4 IPC Athletics World Championships 2013 5 Great North City Games 2013 2 London Paralympic Games 2012 4 U.S. Nationals 2012 2 Mt. Sac Relays 2012 1 Occidental Oxy Invite 2012 1 IPC Athletics

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Erik A. Wikstrom, Sajad Bagherian, Nicole B. Cordero and Kyeongtak Song

chronic ankle instability . Med Sci Sports Exerc . 2016 ; 48 : 776 – 784 . PubMed ID: 26717498 doi:10.1249/MSS.0000000000000859 10.1249/MSS.0000000000000859 26717498 9. Reid A , Birmingham TB , Alcock G . Efficacy of mobilization with movement for patients with limited dorsiflexion after ankle

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Emily R. Hunt, Cassandra N. Parise and Timothy A. Butterfield

. PubMed ID: 9276854 doi: 10.2519/jospt.1997.26.3.138 9276854 25. Reid A , Birmingham TB , Stratford PW , Alcock GK , Giffin JR . Hop testing provides a reliable and valid outcome measure during rehabilitation after anterior cruciate ligament reconstruction . Phys Ther . 2007 ; 87 ( 3

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Ben J. Lee and Charles Douglas Thake

dioxide and O 2 content, using a calibrated Servomex infrared and paramagnetic gas analyzer, respectively (model 1400; Servomex, Crowthorne, UK), and gas volume, via a Harvard dry gas meter (Cranlea, Birmingham, UK). At the end of each exercise period, the rating of overall and peripheral (legs

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Justin M. Stanek, Jake Parish, Richard Rainville and Jeffrey G. Williams

Ther . 1983 ; 4 : 154 – 157 . PubMed ID: 18806446 doi: 10.2519/jospt.1983.4.3.154 22. Makowski A , Birmingham T , Kramer J , Jogi P , Forwell L , Obright K . Test-retest and interrater reliability of goniometric tibial rotation range of motion measurements . Physiother Can . 2005

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Jonathan S. Goodwin, Robert A. Creighton, Brian G. Pietrosimone, Jeffery T. Spang and J. Troy Blackburn

, Birmingham TB , Dombroski CE , et al . Combined effects of a valgus knee brace and lateral wedge foot orthotic on the external knee adduction moment in patients with varus gonarthrosis . Arch Phys Med Rehabil . 2013 ; 94 ( 1 ): 103 – 112 . PubMed ID: 22995151 doi:10.1016/j.apmr.2012.09.004 22995151