Beicker Clint R, Hudspeth L Jared, Shanley Ellen, Tokish John M, Folk Jason
Texas Hill Country Orthopaedics & Sports Medicine, Fredericksburg, Texas, USA.
Piedmont Ortho, Macon, Georgia, USA.
Orthop J Sports Med. 2022 Feb 7;10(2):23259671211068030. doi: 10.1177/23259671211068030. eCollection 2022 Feb.
With a hip abductor tendon tear, widening of the intergluteal space, or "fat stripe," is a characteristic change seen in and around the gluteus medius and minimus.
To determine the relationship of the intergluteal fat stripe in hips with pathologic abductor tears compared with the contralateral side and to evaluate the association of fat stripe size with hip-specific patient-reported outcome measures.
Case series; Level of evidence, 4.
Of the 43 patients (42 female, 1 male; mean age, 56.6 years; range, 38-85 years) who underwent endoscopic gluteus medius repair, 19 met inclusion criteria of preoperative bilateral hip magnetic resonance imaging (MRI) scans and 2-year follow up. A single board-certified fellowship-trained orthopaedic surgeon (J.F.), who was blinded to outcomes, evaluated the MRI scans to measure the intergluteal fat stripe on the operative and nonoperative sides. The 2-year postoperative International Hip Outcome Tool (iHOT-12) and modified Harris Hip Score (mHHS) values were analyzed to determine their relationship to the size of the fat stripe. Statistical analysis was performed using a paired test, and associations were determined using Pearson product correlation as well as nonparametric measurements.
The size of the intergluteal fat stripe differed significantly between the operative and nonoperative sides. The area of the fat stripe on the operative side was 645.73 ± 513.09 mm, and on the nonoperative side it was 313.47 ± 360.71 mm, an average of 332.36 mm greater than the nonoperative side ( = .02). The width of the fat stripe was 9.10 ± 4.60 mm on the operative side and 5.15 ± 3.87 mm on the nonoperative side, 3.95 mm greater than the nonoperative side ( < .01). There was no correlation between the width or area of the fat stripe on the operative side and iHOT-12 or mHHS values at 2-year follow-up.
The study findings indicated that the intergluteal fat stripe is significantly wider and has a significantly larger area in hips with abductor tears compared with unaffected hips. This did not correlate with 2-year patient-reported outcomes.
臀中肌和臀小肌及其周围组织出现特征性改变，即臀间间隙或“脂肪条纹”增宽，提示存在髋外展肌肌腱撕裂。
确定患侧髋部与对侧相比，存在病理性外展肌撕裂时臀间脂肪条纹的关系，并评估脂肪条纹大小与髋部特异性患者报告结局指标之间的关联。
病例系列研究；证据等级为4级。
43例接受内镜下臀中肌修复术的患者（42例女性，1例男性；平均年龄56.6岁；范围38 - 85岁）中，19例符合术前双侧髋部磁共振成像（MRI）扫描及2年随访的纳入标准。由一位获得专科医师资格认证且接受过 fellowship 培训的骨科医生（J.F.）在对结果不知情的情况下评估MRI扫描图像，测量手术侧和非手术侧的臀间脂肪条纹。分析术后2年的国际髋关节结局工具（iHOT - 12）和改良Harris髋关节评分（mHHS）值，以确定它们与脂肪条纹大小的关系。采用配对t检验进行统计分析，并使用Pearson积矩相关以及非参数测量来确定关联。
手术侧和非手术侧的臀间脂肪条纹大小存在显著差异。手术侧脂肪条纹面积为645.73±513.09平方毫米，非手术侧为313.47±360.71平方毫米，手术侧平均比非手术侧大332.36平方毫米（P = 0.02）。手术侧脂肪条纹宽度为9.10±4.60毫米，非手术侧为5.15±3.87毫米，手术侧比非手术侧宽3.95毫米（P < 0.01）。术后2年随访时，手术侧脂肪条纹的宽度或面积与iHOT - 12或mHHS值之间无相关性。
研究结果表明，与未受影响的髋关节相比，存在外展肌撕裂的髋关节的臀间脂肪条纹明显更宽，面积也明显更大。这与患者报告的2年结局无相关性。
