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Association of mid-thigh quadriceps muscle quality with postoperative outcomes in patients with hip osteoarthritis undergoing total hip arthroplasty: a retrospective cohort study

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Abstract

Purpose

Muscle quality is more important than muscle mass for assessing physical function. Computed tomography (CT) is used to evaluate intramuscular fatty infiltration. The mid-thigh quadriceps CT attenuation values (CTV) expressed in Hounsfield units (HU) negatively correlate with physical function. Patients with hip osteoarthritis (HOA) have lower extremity muscle atrophy, including decreased cross-sectional area (CSA), CTV, and muscle strength. Using preoperative CT images, we investigated the association between mid-thigh quadriceps CSA, CTV, and postoperative outcomes in patients with HOA.

Methods

This study included 62 patients who had unilateral HOA (62 hips) and underwent total hip arthroplasty (THA). We investigated the association between preoperative and postoperative Japanese Orthopaedic Association (JOA) hip scores, 12-item Short Form survey (SF-12), mid-thigh quadriceps CSA, and CTV.

Results

The mean age was 64.7 ± 10.1 years, with 15 men (24.2%), and the mean body mass index was 24.3 ± 4.3 kg/m2. Secondary HOA was present in 79.0% of patients. The mean CSA and CTV of the mid-thigh quadriceps on the operative side were 38.8 ± 9.8 cm2 and 40.3 ± 7.8 HU, respectively. Multiple regression analyses adjusted for age and sex showed that preoperative mid-thigh quadriceps CSA was not associated with preoperative and postoperative JOA hip scores or SF-12. The preoperative mid-thigh quadriceps CTV was associated with the postoperative JOA hip score in the gait ability domain and SF-12 in the physical component summary domain.

Conclusion

Preoperative muscle quality is associated with postoperative outcomes in patients who have HOA regardless of age and sex.

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Data availability

The datasets used for analysis in this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8560, Japan

    Hiroki Iida, Yasuhiko Takegami, Yusuke Osawa, Hiroto Funahashi, Yuto Ozawa, Hiroaki Ido, Takamune Asamoto, Keiji Otaka, Shinya Tanaka & Shiro Imagama

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  1. Hiroki Iida
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  2. Yasuhiko Takegami
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Contributions

Hiroki Iida carried out the studies and drafted the manuscript. Hiroki Iida prepared Figs. 1 and 2 and Table 1, 2, 3, and 4. Yasuhiko Takegami, Yusuke Osawa, and Shiro Imagama participated in its design and helped to draft the manuscript. Hiroki Iida, Yasuhiko Takegami, Yusuke Osawa, Hiroto Funahashi, Yuto Ozawa Hiroaki Ido, Takamune Asamoto, Keiji Otaka, and Shinya Tanaka contributed to recruiting the participants and data collection. Data analysis was performed by Hiroki Iida, Yasuhiko Takegami, and Yusuke Osawa. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yasuhiko Takegami.

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Ethical approval

The study protocol was approved by our university’s Committee on Ethics in Human Research and the Institutional Review Board. The study procedures were conducted in accordance with the principles of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Iida, H., Takegami, Y., Osawa, Y. et al. Association of mid-thigh quadriceps muscle quality with postoperative outcomes in patients with hip osteoarthritis undergoing total hip arthroplasty: a retrospective cohort study. International Orthopaedics (SICOT) (2024). https://doi.org/10.1007/s00264-024-06142-3

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