Hypertrophy Training Following A Total Hip Replacement: A Literature Review.

The 16 studies used different exercises, doses, durations, outcome measures and levels of supervision, so the review could not compare them or pool their results: read the 13-of-16 figure as a head count, not a combined effect. The paper's own counts do not reconcile: one passage reports four studies with no significant strength gain and another reports three, against 16 studies in total. One study is listed as a randomised controlled trial in the results table, but its own entry states that enrolment was not randomised, so the table's design labels are not reliable. Most studies were small, and the review itself notes limited statistical power in several of them. Knee replacement studies were added to stand in for missing hip replacement evidence on the assumption that the two joints can be trained the same way, so some of what is reported here was never tested in hip patients. Many of the studies did not test a one-rep maximum, so how hard patients were actually training is unclear in those trials. The search found no study at all of hypertrophy training after the direct anterior approach, the technique the review set out to examine. Only one of the ten hip replacement studies looked at returning to sport or heavy physical activity. The supplied text does not report a formal quality appraisal of the included studies.

The supplied text does not say who funded the review or whether the authors declared any competing interests.

Do not take this as evidence that a particular strengthening programme works after hip replacement. The review combined no results, no two programmes matched, four of the sixteen studies found no significant strength gain, and most of the studies were small.