Volume Increases of the Gluteus Maximus, Gluteus Medius, and Thigh Muscles After Hip Arthroplasty

Background: Muscle atrophy in osteoarthritis (OA) patients is expected to recover after total hip arthroplasty (THA) because of the increase in activity levels. Although some reports have shown an increase in the thigh muscles (Th) after THA, no reports of increases in the gluteal muscles and of analyses of the factors related to muscle recovery have been published. In this study, the changes in the gluteal and Th volumes after THA were quantitatively evaluated using computed tomography (CT) images, and the factors related to muscle recovery were analyzed. Methods: The subjects were 40 OA hips with CT images taken 3 weeks after THA (first postoperative [postop] CT) and more than 2 years after THA (second postop CT). The cross-sectional areas of gluteus maximus (G-max), gluteus medius (G-med), and Th were measured in both CT images. The factors related to muscle recovery that were measured and evaluated were age, gender, days from operation, surgical approach, KellgreneLawrence grades, and hip functional score (Japanese Orthopaedics Association hip score). Results: All measured cross-sectional areas of the operated side increased significantly from the first postop CT to the second postop CT (G-max, 40%; G-med, 11%; and Th, 20%). In the analysis of the factors related to muscle recovery, the increase rate of G-max correlated significantly with patient age, and the increase rate of G-med correlated significantly with the increase in Japanese Orthopaedics Association hip score. Conclusions: Hip OA can lead to atrophy of the gluteal and Th, but the muscle volume can recover more than 2 years after THA. (C) 2016 Elsevier Inc. All rights reserved.