CT evaluation for sarcopenia involving the psoas and paravertebral muscles in patients with total hip arthroplasty.

Abstract

Computed tomography (CT) has been validated in diagnosing sarcopenia in various clinical conditions. To evaluate the core abdominal muscles in terms of sarcopenia in patients with total hip arthroplasty (THA) with and without complication. Retrospective analysis of patients with a pelvic CT revealed 145 consecutive patients with THA. Also, 118 consecutive cases with normal CT scans constituted the control group. The area and density measurements of bilateral psoas (PSA, psoas area; PSD, psoas density) and paravertebral (PVA, paravertebral area; PVD, paravertebral density) muscles were performed at the level of L3 or L4 vertebrae regardless of prosthesis side. All measurements were evaluated in normal cases and in patients with THA, as well as in patients with complicated prostheses. In the whole population and subgroup of patients with bilateral THA, bilateral PSA, PSD, and PVD but not the PVA were lower in patients with THA compared to controls (all p < 0.01). In patients with unilateral prostheses, ipsilateral PSA, PSD, and bilateral PVD but not the PVA were lower compared to controls (all p < 0.01). Furthermore, in patients with unilateral prostheses with complication, only ipsilateral PSD was lower compared to patients with unilateral prostheses without complication (all p < 0.05) and in patients with bilateral prostheses with complication, bilateral PSA, PSD, and PVD but not the PVA were lower compared to patients with bilateral prostheses without complication (all p < 0.05). Sarcopenia indicated by the area and density measurements of core abdominal muscles can be associated with the presence and complication of hip prostheses.