Reduced muscle radiological density, cross-sectional area, and strength of major hip and knee muscles in 22 patients with hip osteoarthritis

Rasch, Anton; Byström, Anders H; Dalén, Nils; Berg, Hans E.

doi:10.1080/17453670710014158

Cited by 184 publications

(174 citation statements)

References 10 publications

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“…This lends support to the validity of our results and emphasizes the proposed function of the iliocapsularis muscle as a hip stabilizer. Although general atrophy of the periarticular hip muscles has been observed in end-stage osteoarthritis [7,13,14], isolated relative changes of muscle dimensions with hip pathologies are rarely reported in the literature [15,21]. One of the few reports describes a reactive hypertrophy of the tensor fascia latae muscle in hips with an ipsilateral abductor tendon tear [21].…”

Section: Discussionmentioning

confidence: 99%

An Increased Iliocapsularis-to-rectus-femoris Ratio Is Suggestive for Instability in Borderline Hips

Haefeli

Steppacher

Babst

et al. 2015

Clinical Orthopaedics &Amp; Related Research

107

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Background The iliocapsularis muscle is an anterior hip structure that appears to function as a stabilizer in normal hips. Previous studies have shown that the iliocapsularis is hypertrophied in developmental dysplasia of the hip (DDH). An easy MR-based measurement of the ratio of the size of the iliocapsularis to that of adjacent anatomical structures such as the rectus femoris muscle might be helpful in everyday clinical use. Questions/purposes We asked (1) whether the iliocapsularis-to-rectus-femoris ratio for cross-sectional area, thickness, width, and circumference is increased in DDH when compared with hips with acetabular overcoverage or normal hips; and (2) what is the diagnostic performance of these ratios to distinguish dysplastic from pincer hips? Methods We retrospectively compared the anatomy of the iliocapsularis muscle between two study groups with symptomatic hips with different acetabular coverage and a control group with asymptomatic hips. The study groups were selected from a series of patients seen at the outpatient clinic for DDH or femoroacetabular impingement. The allocation to a study group was based on conventional radiographs: the dysplasia group was defined by a lateral center-edge (LCE) angle of \ 25°with a minimal acetabular index of 14°and consisted of 45 patients (45 hips); the pincer group was defined by an LCE angle exceeding 39°and consisted of 37 patients (40 hips). The control group consisted of 30 asymptomatic hips (26 patients) with MRIs performed for nonorthopaedic reasons. The anatomy of the iliocapsularis and rectus femoris muscle was evaluated using MR arthrography of the hip and the following parameters: crosssectional area, thickness, width, and circumference. The iliocapsularis-to-rectus-femoris ratio of these four anatomical parameters was then compared between the two study groups and the control group. The diagnostic performance of these ratios to distinguish dysplasia from protrusio was evaluated by calculating receiver operating characteristic (ROC) curves and the positive predictive value (PPV) for a ratio [ 1. Presence and absence of DDH (ground truth) were determined on plain radiographs using the previously mentioned radiographic parameters. Evaluation of radiographs and MRIs was performed in a blinded fashion. The PPV was chosen because it indicates how likely a hip is dysplastic if the iliocapsularis-to-rectus-femoris ratio was [ 1.Results The iliocapsularis-to-rectus-femoris ratio for cross-sectional area, thickness, width, and circumference was increased in hips with radiographic evidence of DDH (ratios ranging from 1.31 to 1.35) compared with pincer (ratios ranging from 0.71 to 0.90; p \ 0.001) and compared with the control group, the ratio of cross-sectional area, thickness, width, and circumference was increased (ratios ranging from 1.10 to 1.15; p ranging from 0.002 to 0.039). The area under the ROC curve ranged from 0.781 to 0.852. For a one-to-one iliocapsularis-to-rectus-femoris ratio, the PPV was 89% (95% confidence interval [CI], 73%-96%)...

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Section: Discussionmentioning

confidence: 99%

An Increased Iliocapsularis-to-rectus-femoris Ratio Is Suggestive for Instability in Borderline Hips

Haefeli

Steppacher

Babst

et al. 2015

Clinical Orthopaedics &Amp; Related Research

107

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“…In contrast to other studies which selected only one plane both in the affected side and normal side [17,18],we choose three different sections. This approach can help to obtain more information about the gluteus medius muscle.…”

Section: Discussionmentioning

confidence: 99%

“…Thus we used CSA combined with muscular RD [17,35,36] to evaluate the atrophy of gluteus medius muscle. The reduced CSA and RD of gluteus medius muscle in patients with DDH implicated reduced muscle strength.…”

Section: Discussionmentioning

confidence: 99%

Changes of gluteus medius muscle in the adult patients with unilateral developmental dysplasia of the hip

Liu

Wen

Tong

et al. 2012

BMC Musculoskelet Disord

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BackgroundThe gluteus medius muscle is essential for gait and hip stability. Changes that occur in the gluteus medius muscles in patients with developmental dysplasia of the hip (DDH) are not well understood. A better understanding of DDH related changes will have positive repercussions toward hip soft tissue reconstruction.Methods19 adult patients with unilateral DDH scheduled for total hip arthroplasty were assessed for: cross-sectional area (CSA), radiological density (RD) and the length of gluteus medius using computed tomograhpy(CT) (scanned before THA). Hip abductor moment arm and gluteus medius activation angle were also measured via hip anteroposterior radiographs.ResultsBoth CSA and RD of gluteus medius muscle were significantly reduced (p < 0.05) in the affected hip compared to the control. In the affected hip, the length of the gluteus medius muscle was reduced by 8-11 % (p < 0.05) while the gluteus medius activation angle was significantly increased (p < 0.05) and the hip abductor moment arm was decreased (p < 0.05).ConclusionsThe gluteus medius showed substantial loss of CSA, RD as well as decreased length in patients with DDH in the affected hip. These changes should be considered in both hip reconstruction and postoperative rehabilitation training in patients with DDH.

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“…In order to limit the inclusion of patients who could have sagittal and coronal plane deformity that might affect anatomic relationships, we excluded patients with: scoliosis [10°, spondylolisthesis greater than grade 1, and prior spine fusion and/or instrumentation. Because of effects on psoas size and appearance [4,6], we also excluded patients with significant hip osteoarthritis or prior hip arthroplasty as well as patients with prior retroperitoneal surgery.…”

Section: Methodsmentioning

confidence: 99%

Anatomy of the psoas muscle and lumbar plexus with respect to the surgical approach for lateral transpsoas interbody fusion

et al. 2010

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Lateral transpsoas interbody fusion (LTIF) is a minimally invasive technique that permits interbody fusion utilizing cages placed via a direct lateral retroperitoneal approach. We sought to describe the locations of relevant neurovascular structures based on MRI with respect to this novel surgical approach. We retrospectively reviewed consecutive lumbosacral spine MRI scans in 43 skeletally mature adults. MRI scans were independently reviewed by two readers to identify the location of the psoas muscle, lumbar plexus, femoral nerve, inferior vena cava and right iliac vein. Structures potentially at risk for injury were identified by: a distance from the anterior aspect of the adjacent vertebral bodies of \20 mm, representing the minimum retraction necessary for cage placement, and extension of vascular structures posterior to the anterior vertebral body, requiring anterior retraction. The percentage of patients with neurovascular structures at risk for leftsided approaches was 2.3% at L1-2, 7.0% at L2-3, 4.7% at L3-4 and 20.9% at L4-5. For right-sided approaches, this rose to 7.0% at L1-2, 7.0% at L2-3, 9.3% at L3-4 and 44.2% at L4-5, largely because of the relatively posterior right-sided vasculature. A relationship between the position of psoas muscle and lumbar plexus is described which allows use of the psoas position as a proxy for lumbar plexus position to identify patients who may be at risk, particularly at the L4-5 level. Further study will establish the clinical relevance of these measurements and the ability of neurovascular structures to be retracted without significant injury.

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Reduced muscle radiological density, cross-sectional area, and strength of major hip and knee muscles in 22 patients with hip osteoarthritis

Cited by 184 publications

References 10 publications

An Increased Iliocapsularis-to-rectus-femoris Ratio Is Suggestive for Instability in Borderline Hips

An Increased Iliocapsularis-to-rectus-femoris Ratio Is Suggestive for Instability in Borderline Hips

Changes of gluteus medius muscle in the adult patients with unilateral developmental dysplasia of the hip

Anatomy of the psoas muscle and lumbar plexus with respect to the surgical approach for lateral transpsoas interbody fusion

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