Masashi Kawasaki1, Yukiharu Hasegawa2, Toshiaki Okura3, Satoshi Ochiai1, Takayoshi Fujibayashi1. 1. Department of Orthopaedic Surgery, Aichi Koseiren Konan Kosei Hospital, Konan, Aichi, Japan. 2. Department of Hip and Knee Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. 3. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Abstract
BACKGROUND: Total hip arthroplasty (THA) through the direct anterior approach (DAA) is known to cause less muscle damage than other surgical approaches. However, more complex primary cases, such as developmental dysplasia of the hip (DDH), might often cause muscle damage. The objective of the present study was to clarify the muscle damage observed 1 year after THA through the DAA for DDH using magnetic resonance imaging. METHODS: We prospectively compared the muscle cross-sectional area (M-CSA) and fatty atrophy (FA) in muscles by magnetic resonance imaging and the Harris hip score before and at 1-year follow-up after THA through the DAA in 3 groups: 37 patients with Crowe group 1 DDH (D1), 13 patients with Crowe group 2 and 3 DDH (D2 + 3), and 12 patients with osteonecrosis as a control. RESULTS: THA through the DAA for D1 displayed significantly decreased M-CSA and significantly increased FA in the gluteus minimus (Gmini), the tensor fasciae latae (TFL), and the obturator internus (OI). Patients with D2 + 3 group did not have decreased M-CSA in the TFL or increased FA in the Gmini. Postoperatively, a significant negative correlation was observed between the M-CSA and FA for the OI in patients with D1 and D2 + 3. CONCLUSION: THA through the DAA for DDH caused the damage in the Gmini, the TFL, and the OI; severe damage was observed in the OI, showing increased FA with decreased M-CSA in patients with both D1 and D2 + 3.
BACKGROUND:Total hip arthroplasty (THA) through the direct anterior approach (DAA) is known to cause less muscle damage than other surgical approaches. However, more complex primary cases, such as developmental dysplasia of the hip (DDH), might often cause muscle damage. The objective of the present study was to clarify the muscle damage observed 1 year after THA through the DAA for DDH using magnetic resonance imaging. METHODS: We prospectively compared the muscle cross-sectional area (M-CSA) and fatty atrophy (FA) in muscles by magnetic resonance imaging and the Harris hip score before and at 1-year follow-up after THA through the DAA in 3 groups: 37 patients with Crowe group 1 DDH (D1), 13 patients with Crowe group 2 and 3 DDH (D2 + 3), and 12 patients with osteonecrosis as a control. RESULTS: THA through the DAA for D1 displayed significantly decreased M-CSA and significantly increased FA in the gluteus minimus (Gmini), the tensor fasciae latae (TFL), and the obturator internus (OI). Patients with D2 + 3 group did not have decreased M-CSA in the TFL or increased FA in the Gmini. Postoperatively, a significant negative correlation was observed between the M-CSA and FA for the OI in patients with D1 and D2 + 3. CONCLUSION: THA through the DAA for DDH caused the damage in the Gmini, the TFL, and the OI; severe damage was observed in the OI, showing increased FA with decreased M-CSA in patients with both D1 and D2 + 3.
Authors: Adam Ivan Semciw; Tania Pizzari; Stephanie Woodley; Anita Zacharias; Michael Kingsley; Rod A Green Journal: Trials Date: 2018-09-20 Impact factor: 2.279