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Assessment of the Hip Flexor Muscles Shortly after Curved Periacetabular Osteotomy using Magnetic Resonance Imaging
Fumihiro Yoshimura1, Taiki Matsunaga1, Koichi Kinoshita1
1Department of Orthopedic Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
Background:
Curved periacetabular osteotomy requires detachment and retraction of the hip flexors. In this study, we evaluated hip flexor muscle status by magnetic resonance imaging (MRI) shortly after curved periacetabular osteotomy.
Methods:
We retrospectively evaluated 60 hips of 56 patients by MRI 1 week and 3 months after curved periacetabular osteotomy performed from August 2017 to December 2019. We classified the condition of the flexors as follows: Grade 0, normal; Grade I, strain/edema; Grade II, partial tear; and grade III, complete tear.
Results:
At 1 week after surgery, the iliacus muscle was classified as grades I and II in 12.0 and 88.0% of hips; psoas as grades 0, I and II in 22.0, 72.0, and 6.0%; sartorius muscle as grades 0, I and II in 6.0, 62.0, and 32.0%; and rectus femoris muscle as grades 0 and I in 86.0 and 14.0%, respectively. At 3 months, 82.0, 88.0, and 96.0% of psoas, sartorius, and rectus femoris muscles, respectively, had improved to grade 0, whereas the iliacus was grades I and II in 94.0 and 6.0%, respectively. These changes in the iliacus muscle at 3 months were not significantly associated with patient characteristics, radiographic data, or clinical scores.
Conclusions:
All the iliacus, 78% of psoas, 94% of sartorius, and 14% of rectus femoris muscles appeared abnormal on MRI 1 week after curved periacetabular osteotomy. However, at 3 months, only 18% of psoas, 12% of sartorius, and 4% of rectus femoris muscles appeared abnormal, whereas all iliacus muscles still appeared abnormal. These abnormalities did not significantly affect clinical scores.
Insights
Magnetic resonance imaging (MRI) revealed significant hip flexor abnormalities after curved periacetabular osteotomy, with most improving by three months, except for the iliacus muscle. These findings did not impact clinical outcomes.
Area of Science:
- Orthopedic surgery
- Musculoskeletal imaging
Background:
- Curved periacetabular osteotomy (CPO) necessitates hip flexor detachment and retraction.
- Assessing the impact of CPO on hip flexor muscles is crucial for understanding post-operative recovery.
Purpose of the Study:
- To evaluate hip flexor muscle status using magnetic resonance imaging (MRI) following CPO.
- To determine the recovery pattern of hip flexor muscles at one week and three months post-surgery.
Main Methods:
- Retrospective analysis of 60 hips (56 patients) undergoing CPO.
- MRI assessment at one week and three months post-operation.
- Classification of hip flexor muscle injury severity (Grade 0-III).
Main Results:
- One week post-op: Iliacus (100%), Psoas (78%), Sartorius (94%), Rectus Femoris (14%) showed abnormalities.
- Three months post-op: Significant improvement observed in Psoas, Sartorius, and Rectus Femoris muscles.
- Iliacus muscle abnormalities persisted in all patients at three months post-op.
Conclusions:
- Post-CPO, hip flexor muscles commonly exhibit MRI-detected abnormalities, particularly the iliacus.
- Most flexor muscles show substantial recovery by three months, but iliacus muscle healing is prolonged.
- Observed muscle abnormalities did not significantly correlate with clinical outcomes.
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