Iwasa Makoto, Uemura Keisuke, Soufi Mazen, Otake Yoshito, Kinoshita Tomofumi, Kutsuna Tatsuhiko, Takashima Kazuma, Hamada Hidetoshi, Sato Yoshinobu, Sugano Nobuhiko, Okada Seiji, Takao Masaki
Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
Division of Information Science, Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Japan.
Int J Comput Assist Radiol Surg. 2025 Apr;20(4):703-711. doi: 10.1007/s11548-025-03321-4. Epub 2025 Jan 21.
Identifying muscles linked to postoperative physical function can guide protocols to enhance early recovery following total hip arthroplasty (THA). This study aimed to evaluate the association of preoperative pelvic and thigh muscle volume and quality with early physical function after THA in patients with unilateral hip osteoarthritis (HOA).
Preoperative Computed tomography (CT) images of 61 patients (eight males and 53 females) with HOA were analyzed. Six muscle groups were segmented from CT images, and muscle volume and quality were calculated on the healthy and affected sides. Muscle quality was quantified using the mean CT values (Hounsfield units [HU]). Early postoperative physical function was evaluated using the Timed Up & Go test (TUG) at three weeks after THA. The effect of preoperative muscle volume and quality of both sides on early postoperative physical function was assessed.
On the healthy and affected sides, mean muscle mass was 9.7 cm/kg and 8.1 cm/kg, and mean muscle HU values were 46.0 HU and 39.1 HU, respectively. Significant differences in muscle volume and quality were observed between the affected and healthy sides. On analyzing the function of various muscle groups, the TUG score showed a significant association with the gluteus maximum volume and the gluteus medius/minimus quality on the affected side.
Patients with HOA showed significant muscle atrophy and fatty degeneration in the affected pelvic and thigh regions. The gluteus maximum volume and gluteus medius/minimus quality were associated with early postoperative physical function. Preoperative rehabilitation targeting the gluteal muscles on the affected side could potentially enhance recovery of physical function in the early postoperative period.
确定与术后身体功能相关的肌肉，可为全髋关节置换术（THA）后促进早期恢复的方案提供指导。本研究旨在评估单侧髋关节骨关节炎（HOA）患者THA术前骨盆和大腿肌肉体积及质量与早期身体功能的相关性。
分析61例HOA患者（8例男性和53例女性）的术前计算机断层扫描（CT）图像。从CT图像中分割出六组肌肉，并计算健康侧和患侧的肌肉体积及质量。使用平均CT值（亨氏单位[HU]）对肌肉质量进行量化。在THA术后三周，采用定时起立行走测试（TUG）评估早期术后身体功能。评估术前双侧肌肉体积和质量对术后早期身体功能的影响。
在健康侧和患侧，平均肌肉质量分别为9.7 cm/kg和8.1 cm/kg，平均肌肉HU值分别为46.0 HU和39.1 HU。患侧与健康侧之间的肌肉体积和质量存在显著差异。在分析各肌肉组的功能时，TUG评分与患侧臀大肌体积和臀中肌/臀小肌质量显著相关。
HOA患者患侧骨盆和大腿区域出现明显的肌肉萎缩和脂肪变性。臀大肌体积和臀中肌/臀小肌质量与术后早期身体功能相关。术前针对患侧臀肌的康复训练可能会在术后早期促进身体功能的恢复。
