Preoperative Gluteal Muscle Atrophy: A Silent Predictor of THA Dislocation.

Centre Hospitalier Universitaire de Nīmes72 enrolled

Overview

This study looks at how fat buildup in hip muscles relates to hip osteoarthritis and less favorable recovery after hip replacement surgery. While it is known that weak gluteal muscles might cause problems, it is not yet proven if this specifically leads to hip dislocation after surgery. The goal of this study is to compare fat buildup in gluteal muscles between patients who had a hip dislocation soon after surgery and those who did not.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Dislocation Total Hip Arthroplasty Muscle Degeneration

Interventions

DislocationDIAGNOSTIC_TEST

One episode of total hip dislocation diagnozied on Xray within 2 years of surgery

No dislocationDIAGNOSTIC_TEST

No experience of dislocation within two years post-surgery

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * primary THA with preoperative CT-scan Exclusion Criteria: * malposition of acetabular implants outside the Lewinneck safe zone, * neurological or cognitive disorders, * associated spinal pathologies (within the context of a hip-spine syndrome), * chronic alcoholism, * aseptic osteonecrosis, * revision surgeries, * late dislocations attributed to polyethylene wear, * replacement following post-traumatic coxarthrosis due to acetabulum injuries. * diameters of the prosthetic heads ≠ 32mm

Locations (1)

CHU Nîmes

Nîmes, Gard, France

Outcomes

Primary Outcomes

Mean Attenuation Ratio

The mean attenuation ratio (MAR), representing muscle fat degeneration, corresponds to the mean grayscale pixels in the selected area, expressed in Hounsfield Units (HU). Subsequently, the segmentation process was applied, selectively retaining pixels within the range of -30 HU to 150 HU. This range corresponds to muscle fibers and intramuscular fat, effectively excluding extra-fascial fat and bone pixels.

Time frame: The CT scan of the pelvis used to plan the operation is performed between one and two months before the surgery.

Secondary Outcomes

Cross-Sectional Area

The cross-sectional area (CSA), measured in square centimeters (cm²) defines the average muscle surface area.

Time frame: The CT scan of the pelvis used to plan the operation is performed between one and two months before the surgery.

Intramuscular Fatty Fraction

Finally, the intramuscular fatty fraction (IFF) or percentage of intramuscular fat was calculated using the IB Delta Suite plug-in with thresholds of -30/0/150. Pixels below -30 HU and above 150 HU were designated as extra-muscular, while pixels ranging between 0 HU and 150 HU represented muscle fibers. Pixels falling between -30 HU and 0 HU denoted intramuscular fat, constituting the IFF.

Time frame: The CT scan of the pelvis used to plan the operation is performed between one and two months before the surgery.

Data from ClinicalTrials.gov

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