Hatem Munif, Feng Richard, Teel Jordan, Martin Hal David
Hip Preservation Center, Baylor University Medical Center, Dallas, Texas.
Texas A&M College of Medicine, Dallas, Texas.
Proc (Bayl Univ Med Cent). 2023 Feb 3;36(3):329-334. doi: 10.1080/08998280.2023.2171704. eCollection 2023.
Partial resection of the lesser trochanter (LT plasty) has been increasingly recommended to treat ischiofemoral impingement. However, there is a lack of studies on the imaging findings following LT plasty. The purpose of this study was to assess magnetic resonance imaging (MRI) changes on the lesser trochanter and surrounding musculotendinous structures following LT plasty to treat ischiofemoral impingement. Twenty-one patients (21 hips) were studied. The LT length and cross-sectional area of the iliopsoas muscle were measured on MRI before and after surgery. The MRIs were performed on average 11 months (range, 3 to 25 months) after surgery. The mean ± standard deviation amount of LT resected (difference between pre- and postoperative LT length) was 7.3 mm ± 2.5 mm. The iliopsoas cross-sectional area decreased after the LT plasty in 95% of the hips (20/21) by an average of 35% ± 16%. The reduction in iliopsoas size had no significant correlation with improvement on the modified Harris Hip Score at a mean follow-up of 17 months after surgery (r = -0.13, = 0.58). The iliopsoas muscle size decreased on average 35% following endoscopic LT plasty. The decrease was not correlated with midterm functional outcomes.
越来越多的人推荐采用小转子部分切除术(小转子成形术)来治疗坐骨股骨撞击症。然而,目前缺乏关于小转子成形术后影像学表现的研究。本研究的目的是评估小转子成形术治疗坐骨股骨撞击症后,小转子及周围肌肉肌腱结构的磁共振成像(MRI)变化。对21例患者(21髋)进行了研究。在手术前后通过MRI测量小转子长度和髂腰肌横截面积。MRI平均在术后11个月(范围3至25个月)进行。切除的小转子平均±标准差量(术前和术后小转子长度之差)为7.3 mm±2.5 mm。95%(20/21)的髋关节在小转子成形术后髂腰肌横截面积减小,平均减小35%±16%。在术后平均17个月的随访中,髂腰肌大小的减小与改良Harris髋关节评分的改善无显著相关性(r = -0.13,P = 0.58)。内镜下小转子成形术后,髂腰肌大小平均减小35%。这种减小与中期功能结果无关。