Abstract
BackgroundMuscle strength around the hip after total hip arthroplasty (THA) is crucial for preventing dislocation and limping. This study aimed to assess and compare muscle volume and degeneration after THA using the posterolateral (PL) and anterolateral (AL) approaches.MethodsSixty-four hips in 64 patients who underwent primary THA were retrospectively analyzed. Patients were segregated into the PL group (35 hips) and AL group (29 hips) for evaluating pre- and postoperative muscle volumes and degeneration around the hip. Computed tomography (CT) examinations were performed preoperatively and 6 months post THA. The muscle volume and Hounsfield units (HU) of the gluteus maximus (G-max), gluteus medius (G-med), tensor fasciae latae, internal obturator muscle, and external obturator muscle were measured.ResultsIn the PL group, the postoperative muscle volume of the G-max significantly increased than the preoperative muscle volume. In contrast, the postoperative muscle volume of the internal obturator muscle was significantly lower than the preoperative muscle volume. The postoperative HU of the internal and external obturator muscles were significantly lower than the preoperative HU. In the AL group, the postoperative muscle volumes of the G-max, G-med, and tensor fasciae latae significantly increased than their preoperative muscle volumes. The postoperative HU of the G-med and tensor fasciae latae were significantly higher than the preoperative HU values.ConclusionThe PL approach can lead to degeneration of the internal and external obturator. The AL approach is more beneficial for recovering the G-med, tensor fasciae latae, and internal obturator muscle than the PL approach.
Highlights
Muscle strength around the hip after total hip arthroplasty (THA) is crucial for preventing dislocation and limping
The PL approach was performed on 35 patients (PL group; nine joints in men and 26 joints in women) with a mean age of 67.1 ± 9.9 years and a mean body mass index (BMI) of 26.5 ± 5.2 kg/m2
The AL approach was performed on 29 patients (AL group; three joints in men and 26 joints in women) with a mean age of 67.4 ± 10 years and a mean BMI of 22.6 ± 4.7 kg/m2
Summary
Muscle strength around the hip after total hip arthroplasty (THA) is crucial for preventing dislocation and limping. This study aimed to assess and compare muscle volume and degeneration after THA using the posterolateral (PL) and anterolateral (AL) approaches. Muscle strength and recovery after THA can affect gait, causing limping and Trendelenburg gait, which can contribute to patients’ dissatisfaction. Evaluating muscle recovery after THA is essential. Muscle recovery after THA may vary depending on the approach. There are no reports evaluating muscle volume and degeneration after THA using the PL and AL approaches. Hounsfield units (HU) are useful for evaluating degeneration because HU vary depending on densities: air, − 1000 HU; fat, − 100 HU; water, 0 HU; muscle, 30–50 HU; and bone, 400–1000. CT image intensity decreases [10]
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