Skip to main content

Advertisement

SpringerLink
Log in

Magnetic resonance-based hip muscles retrospective analysis shows deconditioning and recovery after total hip arthroplasty surgery

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 26 September 2023

Abstract

Purpose

The purpose of this study is to estimate the effect of unilateral hip osteoarthritis (OA) on hip muscle volume and fatty infiltration and to evaluate changes of muscles after total hip arthroplasty (THA) surgery.

Methods

A retrospective analysis was conducted on patients with unilateral hip OA subjected to THA with perioperative pelvic girdle 1.5 T magnetic resonance imaging (MRI). Thirty-five patients were included. Ten of these have also postoperative MRIs. Medius gluteus (MG) and iliopsoas (IP) muscles were manually segmented on the MRI scans, the corresponding 3D muscle geometries were reconstructed, and the volumes extracted. Muscle quality was assessed using the Goutallier classification on coronal MRI images. Volume and muscle quality differences were calculated between healthy and affected side.

Results

Pre-operatively, MG and IP on the affected side presented a mean muscle volume 17.5 ± 18% (p < 0.001) and 14.4 ± 15.8% (p < 0.001) smaller than the healthy counterpart, respectively. Muscles on the affected side showed a significant higher grade of fatty infiltration compared to the healthy side (p < 0.05 for MG; p < 0.001 for IP). At an average follow-up of 13 ± 5.3 months after THA, MG, and IP muscles of the affected hip showed an average 22.8% (p < 0.001) and 28.2% (p < 0.001) volume increase after THA. Also, the healthy side showed a significant increase of muscle volume for IP (17.1% p < 0.001). No significant change for MG muscle was observed.

Conclusions

The study demonstrated preoperative reduced muscle volume and higher fatty infiltration at the muscles of the OA hip compared to the contralateral healthy one. A significant positive effect of THA on hip muscle volume was observed. These findings give an interesting insight on muscle deconditioning and recovery in patients undergoing THA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability of data and materials

The data that support the findings of this study are available from Istituto Ortopedico Rizzoli, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of Istituto Ortopedico Rizzoli.

Abbreviations

OA:

Osteoarthritis

THA:

Total hip replacement

MRI:

Magnetic resonance imaging

MG:

Medius gluteus

IP:

Iliopsoas

References

  1. Damm P, Brackertz S, Streitparth F, Perka C, Bergmann G, Duda GN et al (2019) Muscle atrophy-related increased joint loading after total hip arthroplasty and their postoperative change from 3 to 50 months. Clin Biomech 65:105–109

    Article  Google Scholar 

  2. Graves SC, Dropkin BM, Keeney BJ, Lurie JD, Tomek IM (2016) Does surgical approach affect patient-reported function after primary THA? Clin Orthop 474(4):971–981

    Article  PubMed  Google Scholar 

  3. Bokshan SL, DePasse JM, Daniels AH (2016) Sarcopenia in orthopedic surgery. Orthopedics 39(2):295–300

    Article  Google Scholar 

  4. Babu JM, Kalagara S, Durand W, Antoci V, Deren ME, Cohen E (2019) Sarcopenia as a risk factor for prosthetic infection after total hip or knee arthroplasty. J Arthroplasty 34(1):116–122

    Article  PubMed  Google Scholar 

  5. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48(1):16–31

    Article  PubMed  Google Scholar 

  6. Cawthon PM, Lui L-Y, Taylor BC, McCulloch CE, Cauley JA, Lapidus J et al (2017) Clinical definitions of sarcopenia and risk of hospitalization in community-dwelling older men: the osteoporotic fractures in men study. J Gerontol A Biol Sci Med Sci 72(10):1383–9

    Article  PubMed  PubMed Central  Google Scholar 

  7. Balogun SA, Graves SE, Lorimer M, Cicuttini F, Scott D, Jones G et al (2020) Do older adults with low muscle mass or strength, in the presence of obesity, have an increased risk of joint replacement over 13 years? Calcif Tissue Int 107(1):10–17

    Article  CAS  PubMed  Google Scholar 

  8. Mijnarends DM, Koster A, Schols JMGA, Meijers JMM, Halfens RJG, Gudnason V et al (2016) Physical activity and incidence of sarcopenia: the population-based AGES-Reykjavik Study. Age Ageing 45(5):614–620

    Article  PubMed  PubMed Central  Google Scholar 

  9. Loureiro A, Constantinou M, Diamond LE, Beck B, Barrett R (2018) Individuals with mild-to-moderate hip osteoarthritis have lower limb muscle strength and volume deficits. BMC Musculoskelet Disord 19(1):303

    Article  PubMed  PubMed Central  Google Scholar 

  10. Shorter E, Sannicandro AJ, Poulet B, Goljanek-Whysall K (2019) Skeletal muscle wasting and its relationship with osteoarthritis: a mini-review of mechanisms and current interventions. Curr Rheumatol Rep 21(8):40

    Article  PubMed  PubMed Central  Google Scholar 

  11. Jeon H, Lee S-U, Lim J-Y, Chung SG, Lee SJ, Lee SY (2019) Low skeletal muscle mass and radiographic osteoarthritis in knee, hip, and lumbar spine: a cross-sectional study. Aging Clin Exp Res 31(11):1557–1562

    Article  PubMed  Google Scholar 

  12. Kim YK, Yi SR, Lee YH, Kwon J, Jang SI, Park SH (2018) Effect of sarcopenia on postoperative mortality in osteoporotic hip fracture patients. J Bone Metab 25(4):227–233

    Article  PubMed  PubMed Central  Google Scholar 

  13. Bokshan SL, Han AL, DePasse JM, Eltorai AEM, Marcaccio SE, Palumbo MA et al (2016) Effect of sarcopenia on postoperative morbidity and mortality after thoracolumbar spine surgery. Orthopedics 39(6):e1159-64

    Article  PubMed  Google Scholar 

  14. Kovalenko B, Bremjit P, Fernando N (2018) Classifications in brief: Tönnis classification of hip osteoarthritis. Clin Orthop 476(8):1680–1684

    Article  PubMed  PubMed Central  Google Scholar 

  15. Davico G, Bottin F, Di Martino A, Castafaro V, Baruffaldi F, Faldini C, Viceconti M (2023) Intra-operator repeatability of manual segmentations of the hip muscles on clinical magnetic resonance Images. J Digit Imaging 36(1):143–152

  16. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop 304:78–83

    Article  Google Scholar 

  17. Di Martino A, Geraci G, Stefanini N, Perna F, Mazzotti A, Ruffilli A et al (2020) Surgical repair for abductor lesion after revision total hip arthroplasty: a systematic review. HIP Int 30(4):380–390

    Article  PubMed  Google Scholar 

  18. Arokoski MH, Arokoski JPA, Haara M, Kankaanpää M, Vesterinen M, Niemitukia LH et al (2002) Hip muscle strength and muscle cross sectional area in men with and without hip osteoarthritis. J Rheumatol 29(10):2185–2195

    PubMed  Google Scholar 

  19. Rasch A, Byström AH, Dalen N, Berg HE (2007) Reduced muscle radiological density, cross-sectional area, and strength of major hip and knee muscles in 22 patients with hip osteoarthritis. Acta Orthop 78(4):505–510

    Article  PubMed  Google Scholar 

  20. Grimaldi A, Richardson C, Stanton W, Durbridge G, Donnelly W, Hides J (2009) The association between degenerative hip joint pathology and size of the gluteus medius, gluteus minimus and piriformis muscles. Man Ther 14(6):605–610

    Article  PubMed  Google Scholar 

  21. Uemura K, Takao M, Sakai T, Nishii T, Sugano N (2016) Volume increases of the gluteus maximus, gluteus medius, and thigh muscles after hip arthroplasty. J Arthroplasty 31(4):906-912.e1

    Article  PubMed  Google Scholar 

  22. Xu D, Koyama H, Furuhashi H, Nishikino S, Hoshino H, Matsuyama Y (2017) Comparison of hip muscle volume between fit-and-fill stem and tapered-wedge stem after total hip arthroplasty using the anterolateral approach. J Orthop Sci 22(6):1102–1106

    Article  PubMed  Google Scholar 

  23. Learmonth ID, Young C, Rorabeck C (2007) The operation of the century: total hip replacement. Lancet Lond Engl 370(9597):1508–1519

    Article  Google Scholar 

  24. Wang L, Yin L, Zhao Y, Su Y, Sun W, Chen S et al (2020) Muscle density, but not size, correlates well with muscle strength and physical performance. J Am Med DirAssoc 22(4):751–759.e2

  25. Goodpaster BH, Chomentowski P, Ward BK, Rossi A, Glynn NW, Delmonico MJ et al (2008) Effects of physical activity on strength and skeletal muscle fat infiltration in older adults: a randomized controlled trial. J Appl Physiol Bethesda (1985) 105(5):1498–1503

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Biomedical and Neurimotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy

    Alberto Di Martino, Vanita Castafaro, Giuseppe Geraci, Niccolò Stefanini, Leonardo Tassinari & Cesare Faldini

  2. Ist Orthopedic Department, IRCCS – Istituto Ortopedico Rizzoli, Bologna, Italy

    Alberto Di Martino, Vanita Castafaro, Giuseppe Geraci, Niccolò Stefanini, Leonardo Tassinari & Cesare Faldini

  3. Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy

    Giorgio Davico & Marco Viceconti

  4. Medical Technology Lab, IRCCS – Istituto Ortopedico Rizzoli di Bologna, Bologna, Italy

    Giorgio Davico & Marco Viceconti

Authors
  1. Alberto Di Martino
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Giorgio Davico
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vanita Castafaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giuseppe Geraci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Niccolò Stefanini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Leonardo Tassinari
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marco Viceconti
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Cesare Faldini
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Each author contributed in equal manner to the development of this paper. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alberto Di Martino.

Ethics declarations

Ethics approval and consent to participate

The study has been approved by the local ethics committee (CE AVEC: 486/2020/Oss/IOR) and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Level of Evidence:

IV.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Di Martino, A., Davico, G., Castafaro, V. et al. Magnetic resonance-based hip muscles retrospective analysis shows deconditioning and recovery after total hip arthroplasty surgery. International Orthopaedics (SICOT) 47, 1441–1447 (2023). https://doi.org/10.1007/s00264-023-05762-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-023-05762-5

Keywords

Search

Navigation