Quinn Matthew, Levins James, Mojarrad Mohammadali, O'Donnell Ryan, DeFroda Steven, Haggerty Erin, Evangelista Peter, Tabaddor Ramin
Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI 02903, USA.
Department of Radiology, Brown University, Warren Alpert School of Medicine, Providence, RI 02903, USA.
J Hip Preserv Surg. 2021 Aug 30;8(2):197-201. doi: 10.1093/jhps/hnab058. eCollection 2021 Jul.
Hip abductor tendon tears of the gluteus medius and minimus are becoming a well-recognized source of pain and dysfunction, primarily in middle-age females. Like the rotator cuff, fatty infiltration (FI) can occur after tearing of these tendons. While the association of TFL hypertrophy after abductor tendon tears has been established, its association with FI has not been well studied. Our hypothesis is that hypertrophy of the TFL will be associated with FI of the abductors. All patients >18 years old undergoing primary surgical repair for a confirmed tears on MRI, without a history of prior hip surgery or osteoarthritis, were included. The following measurements were obtained from MRI: TFL cross-sectional area, TFL:sartorius volume ratio, and modified Goutallier grade of gluteus medius and minimus. Seventy patients met inclusion criteria and were divided in two groups, those with ( = 28) and those without FI ( = 42) of the abductors. The FI group was on average older (65 versus 58 years, < 0.00016). TFL hypertrophy and TFL:sartorius volume ratio were significantly associated with FI (= 0.00069). Following abductor tendon tear and subsequent FI, there exists significant TFL hypertrophy in patients without a prior history of hip surgery in our patient cohort.
臀中肌和臀小肌的髋外展肌腱撕裂正成为一种广为人知的疼痛和功能障碍来源,主要发生在中年女性身上。与肩袖一样,这些肌腱撕裂后可能会出现脂肪浸润(FI)。虽然外展肌腱撕裂后阔筋膜张肌(TFL)肥大的关联已得到证实,但其与脂肪浸润的关联尚未得到充分研究。我们的假设是,阔筋膜张肌肥大将与外展肌的脂肪浸润有关。纳入所有年龄大于18岁、因MRI证实的撕裂而接受初次手术修复、无髋关节手术或骨关节炎病史的患者。从MRI中获得以下测量值:阔筋膜张肌横截面积、阔筋膜张肌与缝匠肌体积比,以及臀中肌和臀小肌的改良Goutallier分级。70名患者符合纳入标准,分为两组,一组有外展肌脂肪浸润(n = 28),另一组无外展肌脂肪浸润(n = 42)。脂肪浸润组平均年龄更大(65岁对58岁,P < 0.00016)。阔筋膜张肌肥大和阔筋膜张肌与缝匠肌体积比与脂肪浸润显著相关(P = 0.00069)。在我们的患者队列中,外展肌腱撕裂并随后出现脂肪浸润后,无髋关节手术史的患者存在显著的阔筋膜张肌肥大。