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臀中肌萎缩与对侧和同侧髋关节骨关节炎有关。

Gluteus medius muscle atrophy is related to contralateral and ipsilateral hip joint osteoarthritis.

作者信息

Amaro A, Amado F, Duarte J A, Appell H-J

机构信息

Health School, University of Aveiro, Aveiro, Portugal.

出版信息

Int J Sports Med. 2007 Dec;28(12):1035-9. doi: 10.1055/s-2007-965078. Epub 2007 May 29.

Abstract

In order to understand the role of the GLUTEUS MEDIUS muscle (GM) in hip joint osteoarthritis, the objective of this study was to analyze the correlation between morphometric data of GM samples with osteoarthritis scores of ipsilateral and contralateral hips in 41 patients. GM samples obtained during unilateral hip replacement surgery were used to evaluate muscle fibers in the cross-sectional area (CSA) and other features indicative for muscle aging. Clinical symptoms were assessed by the Lequesne pain score. Hip osteoarthritis was graded by the Kellgren score and by measuring the sum joint space width (sumJSW) at three different articular locations and minimal JSW in a. p. radiographs. Varying degrees of GM muscle atrophy correlated with the pain score; pain score also correlated with radiographic signs of osteoarthritis. GM CSA was significantly correlated with all radiographic signs of the contralateral hip, but only with the sumJSW in the ipsilateral hip. It can be concluded that a weak GM may be the result of ipsilateral osteoarthitis, but may especially predispose the contralateral hip to develop osteoarthritis. This can be associated with an impaired GM capacity to avoid the shock impact in the load transfer during gait. Muscle strengthening is therefore recommended.

摘要

为了了解臀中肌(GM)在髋关节骨关节炎中的作用,本研究的目的是分析41例患者GM样本的形态学数据与同侧和对侧髋关节骨关节炎评分之间的相关性。在单侧髋关节置换手术中获取的GM样本用于评估横截面积(CSA)中的肌纤维以及其他指示肌肉老化的特征。临床症状通过Lequesne疼痛评分进行评估。髋关节骨关节炎通过Kellgren评分以及在前后位X线片上测量三个不同关节位置的关节间隙宽度总和(sumJSW)和最小JSW进行分级。不同程度的GM肌肉萎缩与疼痛评分相关;疼痛评分也与骨关节炎的影像学表现相关。GM的CSA与对侧髋关节的所有影像学表现显著相关,但仅与同侧髋关节的sumJSW相关。可以得出结论,GM薄弱可能是同侧骨关节炎的结果,但可能尤其使对侧髋关节易患骨关节炎。这可能与GM在步态中负荷转移时避免冲击影响的能力受损有关。因此建议进行肌肉强化训练。

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