Department of Sports Medicine, Institute of Sports Medicine of Peking University Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
Beijing Key Laboratory of Sports Injuries, Beijing, China.
BMC Musculoskelet Disord. 2024 Oct 24;25(1):841. doi: 10.1186/s12891-024-07965-2.
(1) to investigate the consecutive changes in hip muscle volume in patients with femoroacetabular impingement syndrome (FAIS) during the initial postoperative period, and (2) to determine the potential effect of the early changes in hip muscle volume on clinical outcomes.
Data between March 2021 and March 2022 was reviewed. Patients diagnosed with FAIS based on clinical symptoms and radiographic findings, and undergoing hip arthroscopic treatment were included. Exclusion criteria were incomplete MRI data, prior history of hip surgery, and concomitant hip conditions including hip osteoarthritis with a Tönnis grade > 1, avascular necrosis, Legg-Calvé-Perthes disease, osteoid osteoma, synovial chondromatosis, pigmented villonodular synovitis, and developmental dysplasia of the hip (DDH). MRI was performed preoperatively and 3, 6, 12-month postoperatively. Cross-sectional area (CSA) of hip muscles including rectus femoris (RF), iliocapsularis (IC), iliopsoas (IP), gluteus medius/minimus complex (G-med/min), and gluteus maximus (G-max) were collected on MRI. The CSA was corrected by body surface area (BSA). Preoperative and a minimum of 2-year postoperative patient-reported outcome (PRO) scores including Visual Analog pain Scale (VAS), modified Harris Hip Score (mHHS), and international Hip Outcome Tool, 12-component form (iHOT-12) were collected. A multivariate linear regression model was built to determine the influence of the potential factors on postoperative PROs.
A total of 76 patients were included in the study. Compared to the preoperative level, decreased volume of RF and G-max, and increased IC/RF ratio were observed at postoperative 3 months (all with P < .05). Both G-med/min and G-max presented decreased volume at postoperative 6 months (all with P < .05). G-med/min presented decreased volume (P = .001) at postoperative 12 months. Changes in RF at postoperative 3 months and 12 months were positively related to improvement of iHOT-12 (Beta = 0.371, P = .012 and Beta = 0.330, P = .026, respectively). Changes in IC at postoperative 6-month was positively related to improvement of mHHS (Beta = 0.367, P = .027) and iHOT-12 (Beta = 0.315, P = .044).
During the initial first year following arthroscopic treatment for FAIS, decreased volume of the RF and gluteal muscles was observed. Early changes in volume of RF and IC were positively correlated to the improvement of minimum 2-year PROs.
Level IV; case series.
（1）研究髋关节撞击综合征（FAIS）患者术后初期髋关节肌肉体积的连续变化，（2）确定髋关节肌肉体积早期变化对临床结果的潜在影响。
回顾了 2021 年 3 月至 2022 年 3 月期间的数据。纳入了根据临床症状和影像学表现诊断为 FAIS 并接受髋关节镜治疗的患者。排除标准为 MRI 数据不完整、既往髋关节手术史以及合并髋关节疾病，包括 Tönnis 分级>1 的髋关节骨关节炎、股骨头缺血性坏死、Legg-Calvé-Perthes 病、骨样骨瘤、滑膜软骨瘤病、色素沉着绒毛结节性滑膜炎和发育性髋关节发育不良（DDH）。术前和术后 3、6、12 个月进行 MRI 检查。在 MRI 上收集包括股直肌（RF）、髂腰肌（IC）、髂腰肌（IP）、臀中肌/小肌复合体（G-med/min）和臀大肌（G-max）在内的髋关节肌肉的横截面积（CSA）。CSA 通过体表面积（BSA）进行校正。收集了术前和至少 2 年的患者报告的结果（PRO）评分，包括视觉模拟疼痛量表（VAS）、改良 Harris 髋关节评分（mHHS）和国际髋关节结果工具 12 分量表（iHOT-12）。建立多元线性回归模型，以确定潜在因素对术后 PRO 的影响。
共有 76 名患者纳入研究。与术前相比，术后 3 个月时 RF 和 G-max 的体积减少，IC/RF 比值增加（均 P<.05）。术后 6 个月时 G-med/min 和 G-max 的体积均减少（均 P<.05）。术后 12 个月时 G-med/min 的体积减少（P=.001）。术后 3 个月和 12 个月时 RF 的变化与 iHOT-12 的改善呈正相关（Beta=0.371，P=.012 和 Beta=0.330，P=.026）。术后 6 个月时 IC 的变化与 mHHS（Beta=0.367，P=.027）和 iHOT-12（Beta=0.315，P=.044）的改善呈正相关。
在 FAIS 关节镜治疗后的最初 1 年内，观察到 RF 和臀肌体积减少。RF 和 IC 体积的早期变化与至少 2 年 PRO 的改善呈正相关。
IV 级；病例系列。
