Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8560, Japan.
Int Orthop. 2024 Jul;48(7):1715-1721. doi: 10.1007/s00264-024-06142-3. Epub 2024 Mar 12.
Muscle quality is more important than muscle mass for assessing physical function. Computed tomography (CT) is used to evaluate intramuscular fatty infiltration. The mid-thigh quadriceps CT attenuation values (CTV) expressed in Hounsfield units (HU) negatively correlate with physical function. Patients with hip osteoarthritis (HOA) have lower extremity muscle atrophy, including decreased cross-sectional area (CSA), CTV, and muscle strength. Using preoperative CT images, we investigated the association between mid-thigh quadriceps CSA, CTV, and postoperative outcomes in patients with HOA.
This study included 62 patients who had unilateral HOA (62 hips) and underwent total hip arthroplasty (THA). We investigated the association between preoperative and postoperative Japanese Orthopaedic Association (JOA) hip scores, 12-item Short Form survey (SF-12), mid-thigh quadriceps CSA, and CTV.
The mean age was 64.7 ± 10.1 years, with 15 men (24.2%), and the mean body mass index was 24.3 ± 4.3 kg/m. Secondary HOA was present in 79.0% of patients. The mean CSA and CTV of the mid-thigh quadriceps on the operative side were 38.8 ± 9.8 cm and 40.3 ± 7.8 HU, respectively. Multiple regression analyses adjusted for age and sex showed that preoperative mid-thigh quadriceps CSA was not associated with preoperative and postoperative JOA hip scores or SF-12. The preoperative mid-thigh quadriceps CTV was associated with the postoperative JOA hip score in the gait ability domain and SF-12 in the physical component summary domain.
Preoperative muscle quality is associated with postoperative outcomes in patients who have HOA regardless of age and sex.
肌肉质量对于评估身体功能比肌肉量更为重要。计算机断层扫描（CT）用于评估肌肉内脂肪浸润。用亨氏单位（HU）表示的大腿中段股四头肌 CT 衰减值（CTV）与身体功能呈负相关。髋骨关节炎（HOA）患者存在下肢肌肉萎缩，包括横截面积（CSA）、CTV 和肌肉力量减小。我们利用术前 CT 图像，研究了 HOA 患者大腿中段股四头肌 CSA、CTV 与术后结果的相关性。
本研究纳入了 62 例（62 髋）接受单侧全髋关节置换术（THA）的 HOA 患者。我们调查了术前和术后日本矫形协会（JOA）髋关节评分、12 项简明健康调查问卷（SF-12）、大腿中段股四头肌 CSA 和 CTV 与术后结果的相关性。
患者平均年龄为 64.7±10.1 岁，男性占 24.2%，平均 BMI 为 24.3±4.3kg/m2。继发性 HOA 占 79.0%。术侧大腿中段股四头肌 CSA 和 CTV 的平均值分别为 38.8±9.8cm 和 40.3±7.8HU。调整年龄和性别后多变量回归分析显示，术前大腿中段股四头肌 CSA 与术前和术后 JOA 髋关节评分或 SF-12 均无相关性。术前大腿中段股四头肌 CTV 与术后步态能力域的 JOA 髋关节评分和生理成分综合域的 SF-12 相关。
不论年龄和性别，HOA 患者术前肌肉质量与术后结果相关。
