Yasuda Tadashi, Ota Satoshi, Yamashita Shinnosuke, Tsukamoto Yoshihiro, Onishi Eijiro
Department of Orthopaedic Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminami-machi, Chuo-ku, Kobe, 650-0047, Japan.
Arthroplasty. 2022 Jul 1;4(1):23. doi: 10.1186/s42836-022-00126-7.
This study aimed to identify the association of preoperative variables of ipsilateral hip abductors with gait function after total hip arthroplasty (THA).
This study enrolled 42 patients who underwent unilateral primary THA for osteoarthritis. Gait speed and Timed Up-and-Go test were conducted 6 months postoperatively. Preoperative composition of the glutei medius and minimus and the upper portion of gluteus maximus was evaluated by computed tomography. Cross-sectional area ratio of individual composition to the total muscle was calculated. Preoperative variables associated with gait speed and Timed Up-and-Go test after THA were identified by using stepwise regression analysis.
Faster gait speed and shorter Timed Up-and-Go test correlated with smaller cross-sectional area of low-density lean tissue or intramuscular adipose tissue (low-density lean tissue plus intramuscular fat) in the glutei medius and minimus and lower cross-sectional area ratio of low-density lean tissue to the total glutei medius and minimus. Faster gait speed and shorter Timed Up-and-Go test also correlated with larger cross-sectional area of lean muscle mass in the gluteus maximus, higher cross-sectional area ratio of lean muscle mass to the total gluteus maximus, and lower cross-sectional area ratio of intramuscular fat or intramuscular adipose tissue to the total gluteus maximus. Faster gait speed additionally correlated with larger total cross-sectional area of the gluteus maximus. Regression analysis showed that the total cross-sectional area of the gluteus maximus and the low-density lean tissue cross-sectional area of the glutei medius and minimus were the explanatory variables of gait speed and Timed Up-and-Go test after THA, respectively.
There was a potential association between preoperative composition of ipsilateral hip abductors and gait function 6 months after THA. This study indicates a predictive role of preoperative assessment of ipsilateral hip abductor composition in the recovery of gait function after THA.
本研究旨在确定全髋关节置换术(THA)后同侧髋外展肌术前变量与步态功能之间的关联。
本研究纳入了42例因骨关节炎接受单侧初次THA的患者。术后6个月进行步态速度和计时起立行走测试。通过计算机断层扫描评估术前臀中肌、臀小肌和臀大肌上部的组成。计算各组成部分与总肌肉的横截面积比。采用逐步回归分析确定与THA后步态速度和计时起立行走测试相关的术前变量。
更快的步态速度和更短的计时起立行走时间与臀中肌和臀小肌中低密度瘦组织或肌内脂肪组织(低密度瘦组织加肌内脂肪)的较小横截面积以及低密度瘦组织与臀中肌和臀小肌总面积的较低横截面积比相关。更快的步态速度和更短的计时起立行走时间还与臀大肌中瘦肌肉质量的较大横截面积、瘦肌肉质量与臀大肌总面积的较高横截面积比以及肌内脂肪或肌内脂肪组织与臀大肌总面积的较低横截面积比相关。更快的步态速度还与臀大肌的更大总横截面积相关。回归分析表明,臀大肌的总横截面积以及臀中肌和臀小肌的低密度瘦组织横截面积分别是THA后步态速度和计时起立行走测试的解释变量。
同侧髋外展肌的术前组成与THA后六个月的步态功能之间存在潜在关联。本研究表明术前评估同侧髋外展肌组成对THA后步态功能恢复具有预测作用。