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髋关节镜手术中,被牵拉肢体的牵引力由刚度系数决定,而刚度系数与肌肉体积显著相关。

The traction force of the pulled limb in hip arthroscopic surgery is determined by stiffness coefficient which is significantly related to muscle volume.

机构信息

Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking University, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.

Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2708-2715. doi: 10.1007/s00167-022-07261-3. Epub 2022 Dec 7.

Abstract

PURPOSE

To verify the relationship between muscle volume, lateral centre-edge angle (LCEA), alpha angle (AA), body mass index (BMI) and Beighton score with stiffness coefficient (SC). To analyse the difference of traction force at different physical states of hip joint capsule.

METHODS

Thirty-six patients who underwent hip arthroscopy operation were included. The volumes of some related muscles were measured in MRI images by 3D Slicer. We recorded and tested differences in traction force of five joint capsule physical states, including before (State 1) and after joint capsule puncture (State 2), after the establishment of anterolateral and mid-anterior approaches (State 3) and after incision of the joint capsule through these two approaches (States 4, 5). The correlation between muscle volume, BMI, LCEA, AA and SC was verified by Spearman test. Poisson regression was used to explain confounding variables.

RESULTS

The average force at State 1 was 531.8 N. There were significant differences in traction force between these five states (p < 0.001). There was a significant positive correlation between muscle volumes and SC (p < 0.001). BMI had no correlation with SC (n.s.). The preoperative LCEA of the affected side was correlated with SC (p = 0.043). AA and SC were not correlated (n.s.).

CONCLUSION

The physical states of the hip joint capsule affected traction force. Muscle volume rather than BMI is an ideal index to estimate preoperative traction force. LCEA affected traction force, whilst AA and Beighton score did not. Measuring the muscle volume can help estimate the most suitable traction force for the patient.

LEVELS OF EVIDENCE

IV.

摘要

目的

验证肌肉体积、外侧中心边缘角(LCEA)、α角(AA)、体重指数(BMI)和 Beighton 评分与僵硬系数(SC)之间的关系。分析髋关节囊在不同物理状态下的牵拉力差异。

方法

纳入 36 例行髋关节镜手术的患者。通过 3D Slicer 对 MRI 图像中的部分相关肌肉体积进行测量。记录并测试髋关节囊五个物理状态下的牵拉力差异,包括关节囊穿刺前(状态 1)和穿刺后(状态 2)、建立前外侧和中前入路后(状态 3)以及通过这两种入路切开关节囊后(状态 4、5)。通过 Spearman 检验验证肌肉体积、BMI、LCEA、AA 和 SC 之间的相关性。采用泊松回归解释混杂变量。

结果

状态 1 的平均力为 531.8 N。这五个状态之间的牵拉力存在显著差异(p < 0.001)。肌肉体积与 SC 呈显著正相关(p < 0.001)。BMI 与 SC 无相关性(n.s.)。患侧术前 LCEA 与 SC 相关(p = 0.043)。AA 和 SC 不相关(n.s.)。

结论

髋关节囊的物理状态影响牵拉力。肌肉体积而不是 BMI 是估计术前牵拉力的理想指标。LCEA 影响牵拉力,而 AA 和 Beighton 评分则没有影响。测量肌肉体积有助于估计患者最适合的牵拉力。

证据水平

IV。

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