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Changes in psoas muscle size and ambulatory function after internal hemipelvectomy without reconstruction
Nicholas J Dunbar1, Yuhui M Zhu1, John E Madewell2
1Department of Mechanical Engineering, Rice University, Houston, Texas, USA.
The Bone & Joint Journal
|February 28, 2023
Summary
Psoas muscle recovery and minimizing limb-length discrepancy (LLD) after internal hemipelvectomy are key for improving patient ambulatory function. Monitoring psoas muscle size aids rehabilitation strategies for better outcomes.
Area of Science:
- Orthopedics
- Oncology
- Rehabilitation Medicine
Background:
- Internal hemipelvectomy is a treatment for pelvic sarcoma, but functional recovery varies.
- Psoas muscle recovery and limb-length discrepancy (LLD) may influence functional outcomes.
Purpose of the Study:
- To assess the association between psoas muscle recovery and ambulatory function after internal hemipelvectomy.
- To evaluate the correlation between LLD and functional outcomes.
Main Methods:
- Retrospective evaluation of 12 pelvic sarcoma patients post-hemipelvectomy.
- Analysis of T1-weighted MR images for psoas muscle size and LLD at multiple intervals.
- Correlation with Timed Up and Go (TUG) test and gait speed outcomes.
Main Results:
- Increased psoas muscle size correlated positively with gait speed improvement (r=0.66).
- LLD at 3 months postoperatively correlated negatively with TUG (r=-0.71) and gait speed (r=-0.61).
- Psoas muscle changes correlated with functional improvement; some patients did not regain preoperative muscle size.
Conclusions:
- Psoas muscle strengthening and minimizing LLD are crucial for optimal ambulatory function post-hemipelvectomy.
- LLD and hip musculature changes are significant prognostic factors for clinical outcomes.
- Monitoring psoas muscle size changes can guide rehabilitation strategies.
