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髋外展肌萎缩与髋骨关节炎患者的临床严重程度相关。

Atrophy of hip abductor muscles is related to clinical severity in a hip osteoarthritis population.

作者信息

Zacharias Anita, Green Rodney A, Semciw Adam, English Daniel J, Kapakoulakis Theo, Pizzari Tania

机构信息

Department of Pharmacy and Applied Science, College of Science, Health and Engineering, La Trobe University, Victoria.

Sport, Exercise and Rehabilitation Research Focus Area, La Trobe University, Victoria.

出版信息

Clin Anat. 2018 May;31(4):507-513. doi: 10.1002/ca.23064. Epub 2018 Mar 8.

Abstract

Osteoarthritis mainly affects weight-bearing joints such as the hip and knee and is the most common form of arthritis. Greater muscle atrophy with fatty infiltration of gluteal muscles and decreased hip abduction strength has previously been identified with increasing severity of radiological hip OA. However, it is well documented that radiographic findings of OA do not always correlate with clinical severity. The aim of this secondary analysis was to examine whether atrophy and strength of gluteus maximus (GMax), medius (GMed), minimus (GMin), and tensor fascia lata (TFL) is associated with the clinical severity of OA. Twenty participants with unilateral hip OA and 20 age- and sex-matched asymptomatic controls were classified on the basis of clinical severity (mild, moderate-severe and asymptomatic groups) using the Oxford hip score. Muscle volumes of GMax, GMed, GMin, and TFL were determined using magnetic resonance imaging and expressed as asymmetry between limbs. A hand-held dynamometer was used to identify hip rotation and abduction strength. Regression analyzes were used to identify the association between muscle asymmetry and patient-reported severity of hip OA. Both symptomatic groups (mild and moderate-severe) demonstrated significant asymmetry in GMax (P < 0.01) and GMin (P < 0.01). GMed asymmetry was associated with only the moderate-severe symptomatic group. Hip abduction strength was reduced in both symptomatic groups. Gluteal muscle atrophy was associated with the clinical severity of OA. Clinical severity could be a useful tool for clinicians interpreting likely gluteal muscle changes and planning rehabilitation strategies for hip OA patients. Clin. Anat. 31:507-513, 2018. © 2018 Wiley Periodicals, Inc.

摘要

骨关节炎主要影响负重关节,如髋关节和膝关节,是最常见的关节炎形式。先前已发现,随着放射性髋关节骨关节炎严重程度的增加,臀肌脂肪浸润导致的肌肉萎缩更严重,髋关节外展力量下降。然而,有充分的文献记载,骨关节炎的影像学表现并不总是与临床严重程度相关。这项二次分析的目的是研究臀大肌(GMax)、臀中肌(GMed)、臀小肌(GMin)和阔筋膜张肌(TFL)的萎缩和力量是否与骨关节炎的临床严重程度相关。根据牛津髋关节评分,将20名单侧髋关节骨关节炎患者和20名年龄及性别匹配的无症状对照者按临床严重程度(轻度、中度 - 重度和无症状组)进行分类。使用磁共振成像确定GMax、GMed、GMin和TFL的肌肉体积,并表示为双侧肢体之间的不对称性。使用手持测力计确定髋关节旋转和外展力量。采用回归分析来确定肌肉不对称与患者报告的髋关节骨关节炎严重程度之间的关联。两个有症状组(轻度和中度 - 重度)在GMax(P < 0.01)和GMin(P < 0.01)方面均表现出显著不对称。GMed不对称仅与中度 - 重度有症状组相关。两个有症状组的髋关节外展力量均降低。臀肌萎缩与骨关节炎的临床严重程度相关。临床严重程度可能是临床医生解释可能的臀肌变化并为髋关节骨关节炎患者制定康复策略的有用工具。临床解剖学。31:507 - 513,2018。©2018威利期刊公司。

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