Isokinetic strength of the trunk flexor muscles after surgical repair for incisional hernia

PURPOSE: The repair of incisional hernias can be accomplished by open or laparoscopic techniques. The Biodex(®) dynamometer measures muscle strength during isokinetic movement. The objectives of this study are to compare the strength of the trunk flexors between patients who underwent repair for incisional hernia and a control group, and to compare trunk flexion after two kinds of operative techniques for incisional hernias with and without approximation of the rectus abdominis muscles. METHODS: The trunk flexion of 30 patients after different operative techniques for midline incisional hernias and of 12 healthy subjects was studied with the Biodex(®) isokinetic dynamometer. RESULTS: The mean torque/weight (N m/kg) for trunk flexion was significantly higher in the control group compared to the patient group after incisional hernia repair. A significantly higher peak torque/weight [coefficient 24.45, 95% confidence interval (CI) −0.05; 48.94, P = 0.05] was found in the two-layered suture technique without mesh compared to the laparoscopic technique after adjusting for gender. CONCLUSIONS: The isokinetic strength of the trunk flexor muscles is reduced after an operation for incisional hernia. There is some evidence that a two-layered suture repair with approximation of the rectus abdominis muscles results in higher isokinetic strength of the trunk flexor muscles compared to the laparoscopic technique.