Preoperative gluteus medius muscle atrophy as a predictor of walking ability after total hip arthroplasty

Nankaku, Manabu; Tsuboyama, Tadao; Aoyama, Tomoki; Kuroda, Yutaka; Ikeguchi, Ryosuke; Matsuda, Shinya

doi:10.1298/ptr.e9884

Cited by 21 publications

(14 citation statements)

References 29 publications

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“…According to the analysis of the linear regression model, when the FO increased by 2.3–2.9 mm, the abductor and external rotator moment arms increased, and the other muscle moment arms decreased by less than 5% ( Tables 2 , 3 ). Nankaku et al (2016) have reported that an abnormal gait pattern caused by asymmetrical frontal motion was associated with muscle atrophy of the hip abductor muscle before THA. The hip abductor moment arm rising due to an FO increase following THA may compensate for abductor weakness caused by muscle atrophy, which could improve work efficiency and improve gait imbalance.…”

Section: Discussionmentioning

confidence: 99%

Optimizing the Femoral Offset for Restoring Physiological Hip Muscle Function in Patients With Total Hip Arthroplasty

Zheng

Chen

et al. 2021

Front. Bioeng. Biotechnol.

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ObjectiveFemoral offset (FO) restoration is significantly correlated with functional recovery following total hip arthroplasty (THA). Accurately assessing the effects of FO changes on hip muscles following THA would help improve function and optimize functional outcomes. The present study aimed to (1) identify the impact of FO side difference on the hip muscle moment arms following unilateral THA during gait and (2) propose the optimal FO for a physiological hip muscle function.MethodsIn vivo hip kinematics from eighteen unilateral THA patients during gait were measured with a dual-fluoroscopic imaging system. The moment arms of thirteen hip muscles were calculated using CT-based 3D musculoskeletal models with the hip muscles’ lines of actions. The correlation coefficient (R) between FO and hip muscle moment arm changes compared with the non-implanted hip was calculated. We considered that the FO reconstruction was satisfactory when the abductor moment arms increased, while the extensor, adductor, and flexor moment arms decreased less than 5%.ResultsA decreased FO following THA was significantly correlated with a decrease of the abductor and external rotator moment arms during the whole gait (R > 0.5) and a decrease of extensor moment arms during the stance phase (R > 0.4). An increased FO following THA was significantly associated with shorter flexor moment arms throughout the gait (R < −0.5) and shorter adductor moment arms in the stance phase (R < −0.4). An increase in FO of 2.3–2.9 mm resulted in increased abductor moment arms while maintaining the maximum decrease of the hip muscles at less than 5.0%.ConclusionAn increase of 2–3 mm in FO could improve the abductor and external rotator function following a THA. Accurate surgical planning with optimal FO reconstruction is essential to restoring normal hip muscle function in THA patients.

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Section: Discussionmentioning

confidence: 99%

Optimizing the Femoral Offset for Restoring Physiological Hip Muscle Function in Patients With Total Hip Arthroplasty

Zheng

Chen

et al. 2021

Front. Bioeng. Biotechnol.

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“…GMed size was smaller on the affected side in severe OA than on the contralateral side or in controls Nankaku M et al 126) Female patients with unilateral THA (n=74) Preoperative gluteus medius atrophy was correlated to limping after THA Momose T et al 127) Patients with unilateral hip OA (n=50) Hip abd. strength was correlated to HHS/CT density Hip abd.…”

Section: Discussionmentioning

confidence: 99%

Does low back pain or leg pain in gluteus medius syndrome contribute to lumbar degenerative disease and hip osteoarthritis and vice versa? A literature review

Kameda

Tanimae²,

Kihara³

et al. 2020

J Phys Ther Sci

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Gluteus medius syndrome is one of the major causes of back pain or leg pain and is similar to greater trochanteric pain syndrome, which also presents with back pain or leg pain. Greater trochanteric pain syndrome is associated with lumbar degenerative disease and hip osteoarthritis. The objective of this review was to demonstrate gluteus medius syndrome as a disease entity by reviewing relevant articles to elucidate the condition. [Methods] Gluteus medius syndrome was defined as myofascial pain syndrome arising from the gluteus medius. We performed a search of the literature using the following keywords: "back pain", "leg pain", "greater trochanteric pain syndrome", "degenerative lumbar disease", "hip osteoarthritis", and "gluteus medius". We reviewed articles related to gluteus medius syndrome and described the findings in terms of diagnosis and treatment based on the underlying pathology. [Results] A total of 135 articles were included in this review. Gluteus medius syndrome is similar as a disease entity to greater trochanteric pain syndrome, which presents with symptoms of low back pain and leg pain. Gluteus medius syndrome is also related to lumbar degenerative disease, hip osteoarthritis, knee osteoarthritis, and failed back surgery syndrome. [Conclusion] Accurate diagnosis of gluteus medius syndrome and appropriate treatment could possibly improve lumbar degenerative disease and osteoarthritis of the hip and knee, as well as hip-spine syndrome and failed back surgery syndrome.

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“…The pre-operative strength of muscles stabilizing the pelvis during walking may be a determinant of postoperative improvement of gait function. Analogous studies have demonstrated the impact of pre-operative quadriceps strengthening on results obtained shortly after replacement [36].…”

Section: Personalization Of the Rehabilitation Programmentioning

confidence: 93%

“…Screening performed before the operation to identify people with this problem will allow personalization of the rehabilitation process, taking into account existing muscle dysfunction. This will allow the setting of training goals appropriate to the patient's needs and a more rapid improvement of gait function [36]. Pre-operative training may also strengthen the middle gluteal muscles.…”

Section: Personalization Of the Rehabilitation Programmentioning

confidence: 99%

Personalized rehabilitation therapy in obese and elderly patients undergoing hip replacement surgery

Skalski¹,

Socha-Kania²,

Kozioł-Montewka³

et al. 2019

hpc

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Authors' contribution Wkład autorów: A. Study design/planning zaplanowanie badań B. Data collection/entry zebranie danych C. Data analysis/statistics dane-analiza i statystyki D. Data interpretation interpretacja danych E. Preparation of manuscript przygotowanie artykułu F. literature analysis/search wyszukiwanie i analiza literatury G. Funds collection zebranie funduszy Summary Due to aging of the population and the desire of people to maintain the best possible mobility, the demand for hip replacement is increasing. As a result, personalization of physical therapy after surgery is needed to achieve the best possible outcomes. However, patients undergoing hip replacement surgery often have additional factors, such as advanced age and obesity, which may hinder the process of rehabilitation. The aim of this study was to review the need and recommendations for personalized physical therapy before and after hip replacement surgery in patients with co-morbid factors such as advanced age and obesity. The research literature emphasizes the importance of effective recovery following hip replacement surgery. Older patients may require prolonged postoperative rehabilitation due to the type of surgery, muscle weakness or cognitive dysfunction. Proprioception and balance disorders may benefit from training on an unstable surface aimed at learning safe falling and getting up after a fall. Weakened gluteal muscles which may be present in the elderly and obese may benefit from strength training in the preoperative period. Excessive exposure of the elderly and obese to thromboembolic complications necessitate the inclusion in rehabilitation programs of exercises based on active ankle movement.

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Preoperative gluteus medius muscle atrophy as a predictor of walking ability after total hip arthroplasty

Cited by 21 publications

References 29 publications

Optimizing the Femoral Offset for Restoring Physiological Hip Muscle Function in Patients With Total Hip Arthroplasty

Optimizing the Femoral Offset for Restoring Physiological Hip Muscle Function in Patients With Total Hip Arthroplasty

Does low back pain or leg pain in gluteus medius syndrome contribute to lumbar degenerative disease and hip osteoarthritis and vice versa? A literature review

Personalized rehabilitation therapy in obese and elderly patients undergoing hip replacement surgery

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