Preliminary Quadriceps Muscle Contraction in the Early Rehabilitation of Hip and Knee Arthroplasty

Background: Muscle latency is an often-overlooked factor contributing to increased implant wear and higher rates of hip and knee osteoarthritis. Latency reduces the protective role of muscles against external joint loads during movement initiation, leading to cumulative microtrauma. This study investigates whether preliminary quadriceps contraction can mitigate these adverse effects during early rehabilitation after arthroplasty. Materials and methods: The study was conducted in two university hospitals in Sofia, Bulgaria, including 46 patients (mean age 63.76 ± 9.49 years): 25 with hip arthroplasty and 21 with knee arthroplasty. Participants were randomly assigned to a control group (n = 25; 13 hip, 12 knee: standard postoperative advice) or an experimental group (n = 21; 12 hip, 9 knee: standard advice plus preliminary quadriceps contraction). Primary outcome: pain intensity (VAS). Secondary outcomes: range of motion (ROM, %), manual muscle testing (MMT, %), thigh circumference difference (cm), and success rate of preliminary quadriceps contraction (%). Results: Both groups improved after one month (p < 0.05), but the experimental group showed significantly greater improvement (p < 0.05). Higher success rates of preliminary quadriceps contraction correlated with greater improvements in all outcomes (p < 0.05). Conclusions: Preliminary quadriceps contraction enhances standard postoperative advice by reducing pain, improving mobility and muscle strength, and reducing hypotrophy during early rehabilitation after hip and knee arthroplasty. Patients should be encouraged to perform it consistently, even when pain subsides.