Department of Physiotherapy, NU Hospital Group, Trollhättan/Uddevalla, Sweden.
Institute of Clinical Science, Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Ann Med. 2024 Dec;56(1):2388701. doi: 10.1080/07853890.2024.2388701. Epub 2024 Aug 14.
Hip osteoarthritis is a common cause of disability and surgery is often unavoidable. Patient satisfaction is high and functional ability improves after surgery. However, residual impairment and pain are common. Degenerative changes in tendons and muscles are probable causes. The aim of this study is to investigate gluteus medius (GMED) tendon degeneration in relation to muscle strength, physical function and walking distance before and one year after total hip replacement.
In total, 18 patients were examined pre- and post-operatively, of whom 15 were available in the final analysis. Muscle strength, physical function and walking distance were assessed. Tendon biopsies were assessed microscopically, and the total degeneration score (TDS) was calculated.
A correlation between the TDS and muscle strength was found for the hamstrings, GMED and quadriceps pre- or post-operatively. No correlations were found between the TDS and functional ability. Functional ability and muscle strength improved significantly after surgery.
Our results indicate a correlation between tendon degeneration and the muscle strength of the hip and knee in patients with hip OA and one year after THR. To minimise post-operative residual discomfort, rehabilitation programs should probably be modified over time to match the pre- and post-operative needs. Further studies are needed.This study was registered at https://www.researchweb.org/is/vgr/project/279039 (in Swedish).
髋关节骨关节炎是导致残疾的常见原因，通常需要手术治疗。患者术后满意度高，功能能力改善，但仍存在残余损伤和疼痛。肌腱和肌肉的退行性变化可能是其原因。本研究旨在探讨全髋关节置换术前和术后 1 年臀中肌（GMED）肌腱退变与肌肉力量、身体功能和步行距离的关系。
共对 18 例患者进行了术前和术后检查，其中 15 例在最终分析中可用。评估肌肉力量、身体功能和步行距离。对肌腱活检进行显微镜评估，并计算总退变评分（TDS）。
术前或术后 GMED、股四头肌和腘绳肌的 TDS 与肌肉力量呈正相关。TDS 与功能能力之间无相关性。术后功能能力和肌肉力量明显改善。
我们的研究结果表明，髋关节骨关节炎患者的肌腱退变与髋关节和膝关节的肌肉力量相关，并且在 THR 术后 1 年也存在相关性。为了最大程度减少术后残余不适，康复计划可能需要随着时间的推移进行调整，以满足术前和术后的需求。需要进一步研究。本研究在 https://www.researchweb.org/is/vgr/project/279039（瑞典语）上注册。
