Assessment of Fatty Degeneration of the Gluteal Muscles in Patients With THA Using MRI: Reliability and Accuracy of the Goutallier and Quartile Classification Systems

Engelken, F.; Wassilew, Georgi I.; Köhlitz, Torsten; Brockhaus, Sebastian; Hamm, Bernd; Perka, Carsten; Diederichs, und Gerd

doi:10.1016/j.arth.2013.04.045

Cited by 86 publications

(89 citation statements)

References 26 publications

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“…No correlation could be made with the grading of tendon and muscle pathology to histological or pathological specimens as these data were not available. Interobserver variability in the assessment of tendon pathology and muscle atrophy was not included in our study; previous literature has demonstrated the reliability of the Goutallier staging system by MRI [37][38][39]. Lastly, MR imaging in this study did not include 3.0-T systems as this was not a routine protocol at our institution.…”

Section: Discussionmentioning

confidence: 81%

“…Gluteus medius and gluteus minimus tendon pathology was graded as normal, tendinosis (intermediate signal, not fluid), low-grade partial thickness tear (<50 % tendon fluid signal), high-grade partial thickness tear (≥50 % tendon fluid signal), or full thickness tear (complete fluid signal). The gluteus medius and gluteus minimus were graded for fatty muscle atrophy using the classification system established by Goutallier et al [36][37][38], which compares the amount of fat to the amount of muscle for rotator cuff muscle atrophy but has been applied elsewhere in the body [39]. Atrophy grading score 0 was assigned for normal muscle (no fat), score 1 for minimal atrophy (some fatty streaks), score 2 for mild atrophy (fat infiltration less than muscle), score 3 for moderate atrophy (fat infiltration equal to muscle), and score 4 for marked atrophy (fat infiltration greater than muscle).…”

Section: Evaluation Of Mri Examinationsmentioning

confidence: 99%

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Prevalence and pattern of gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI

et al. 2015

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Section: Discussionmentioning

confidence: 81%

Section: Evaluation Of Mri Examinationsmentioning

confidence: 99%

Prevalence and pattern of gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI

et al. 2015

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“…Image evaluation. The analysis of fatty degeneration of muscle was performed using the modified technique described by Engelken et al 19 In brief, the superior-most slice of the greater trochanter was defined as the baseline. Six slices proximal to the baseline were withdrawn and the next three consecutive slices were chosen for evaluation.…”

Section: Methodsmentioning

confidence: 99%

“…For further analysis fat was defined by taking the mean values of the intensity of fat and adding two standard deviations. 19 Then, an ROI was applied to the ipsilateral iliac muscle to define the mean value of the intensity of muscle. For further analysis, muscle was defined by taking the mean values of the intensity of muscle and adding two standard deviations.…”

Section: Methodsmentioning

confidence: 99%

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Significant muscle damage after multiple revision total hip replacements through the direct lateral approach

Roth

Abdel

Wauer

et al. 2014

The Bone & Joint Journal

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Intact abductors of the hip play a crucial role in preventing limping and are known to be damaged through the direct lateral approach. The extent of trauma to the abductors after revision total hip replacement (THR) is unknown. The aim of this prospective study was to compare the pre- and post-operative status of the gluteus medius muscle after revision THR. We prospectively compared changes in the muscle and limping in 30 patients who were awaiting aseptic revision THR and 15 patients undergoing primary THR. The direct lateral approach as described by Hardinge was used for all patients. MRI scans of the gluteus medius and functional analyses were recorded pre-operatively and six months post-operatively. The overall mean fatty degeneration of the gluteus medius increased from 35.8% (1.1 to 98.8) pre-operatively to 41% (1.5 to 99.8) after multiple revision THRs (p = 0.03). There was a similar pattern after primary THR, but with considerably less muscle damage (p = 0.001), indicating progressive muscle damage. Despite an increased incidence of a positive Trendelenburg sign following revision surgery (p = 0.03) there was no relationship between the cumulative fatty degeneration in the gluteus medius and a positive Trendelenburg sign (p = 0.26). The changes associated with other surgical approaches to the hip warrant investigation.

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Muscle Size and Quality of the Gluteal Muscles and Tensor Fasciae Latae in Women with Greater Trochanteric Pain Syndrome

et al. 2019

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Greater trochanteric pain syndrome (GTPS) is prevalent in women and severely impacts quality of life. A key muscle group demonstrating reduced strength are the hip abductors. An understanding of specific muscles affected will help guide targeted rehabilitation. Objectives of this case–control study were to compare gluteal and tensor fasciae latae (TFL) muscle size and quality (fatty infiltration) in women with symptomatic GTPS to asymptomatic age‐matched female controls. Magnetic resonance imaging of 16 women with GTPS (mean age 55.75 years, range 23–69) and 15 asymptomatic controls (mean age 55.60 years, range 31–66) was undertaken. Muscle volumes of the gluteus maximus, gluteus medius, gluteus minimus, and TFL were calculated. Fatty infiltration was rated using the Goutallier classification system for all muscles in their entirety, as well as anterior and posterior segments of gluteus medius and minimus. Muscle volumes and fatty infiltration were compared between groups. Significantly smaller muscle volumes were identified in the symptomatic group for the upper (P = 0.01) and lower (P = 0.04) portions of gluteus maximus, gluteus medius (P = 0.03), and gluteus minimus (P = 0.02). There was no difference in TFL (P = 0.18). Symptomatic participants displayed significantly greater fatty infiltration in gluteus maximus upper (P = 0.021) and lower (P = 0.049) when adjusted for BMI, and gluteus minimus (P = 0.018), particularly in the posterior portion (P = 0.04). Anterior gluteus minimus demonstrated high amounts of fatty infiltration in both groups. Gluteal muscle atrophy and fatty infiltration in women with GTPS suggests gluteus maximus and minimus may be an important target for rehabilitation. Clin. Anat., 33:1082‐1090, 2020. © 2019 Wiley Periodicals, Inc.

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Assessment of Fatty Degeneration of the Gluteal Muscles in Patients With THA Using MRI: Reliability and Accuracy of the Goutallier and Quartile Classification Systems

Cited by 86 publications

References 26 publications

Prevalence and pattern of gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI

Prevalence and pattern of gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI

Significant muscle damage after multiple revision total hip replacements through the direct lateral approach

Muscle Size and Quality of the Gluteal Muscles and Tensor Fasciae Latae in Women with Greater Trochanteric Pain Syndrome

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