What happens to the gluteus medius in young and middle-aged patients with hip dysplasia?

Lixin Chen; Yunlong Wu; Zhenqiu Chen; Chi Zhou; Yinuo Fan; Zhongfeng Li; Minghai Chen; Jiahao Zhang; Yupeng Liang; Zhiming Wei

doi:10.1007/s00264-021-05271-3

What happens to the gluteus medius in young and middle-aged patients with hip dysplasia?

Int Orthop. 2022 Apr;46(4):761-768. doi: 10.1007/s00264-021-05271-3. Epub 2022 Jan 6.

Authors

Affiliations

¹ Guangdong Province, Huizhou Herbalist Doctor Hospital, Guangzhou University of Chinese Medicine, Huizhou, 516000, China.
² The First Clinical Medical College, Guangdong Province, Guangzhou University of Chinese Medicine, 12 Jichang Road, Baiyun District, Guangzhou, 510405, China.
³ The Department of Orthopedics, Guangdong Province, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China. chenzq2019@126.com.
⁴ The Department of Orthopedics, Guangdong Province, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.

PMID: 34988620
DOI: 10.1007/s00264-021-05271-3

Abstract

Background: Much research has focused on quantifying the bony characteristics of patients with developmental dysplasia of the hip (DDH). Far less attention, however, has been paid to muscle abnormalities around the hip such as those in the gluteus medius (GM).

Methods: We retrospectively examined clinical and imaging data, such as the age of onset and computed tomography (CT) findings, in 108 consecutive hips. Subjects for the control group were selected from our radiology database. Two readers independently evaluated the length (LGM), cross-sectional area (CSA), width (WGM), and thickness (TGM) of the GM and arm of GM (AGM) and angle of the GM activation (AOA) and bony parameters including the acetabulum-head index (AHI), lateral central edge angle (LCEA), acetabular index (AI), femoral offset (FO), and height of the rotation centre of femoral head (HCFH) among all cases using the imaging data.

Results: The patient group included 108 hips. The AGM, LGM, CSA, and TGM were lower in the DDH patients, while AOA was higher. However, there was no significant difference in the WGM between the two groups. Multiple linear regression analysis showed that AGM and AOA were independent factors affecting LCEA. The following regression equation was used: Y(LCEA) = 5.377 * X1 (AGM) - 0.310 * X2 (AOA) - 11.331. The mechanical characteristics of the GM and many bony parameters were significantly correlated (the AGM and AHI, LCEA, AI, FO, but not HCFH; AOA and AHI, LCEA, AI, but not FO or HCFH). The CSA was positively correlated with only HCFH. The rest were not statistical significance linear correlation. The multivariate regression results showed that the age of onset was positively correlated with AGM (r = 0.467). The regression equation used was Y = 9.0 * X (age of onset) - 11.4.

Conclusion: We found difference in the morphological and mechanical characteristics of the GM between hips with DDH and hips of normal morphology. Of note, the mechanical characteristics of the GM were influenced by bony parameters in patients with DDH.

Keywords: Computed tomography; Developmental dysplasia of the hip; Gluteus medius.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acetabulum
Hip Dislocation*
Hip Dislocation, Congenital* / complications
Hip Dislocation, Congenital* / diagnostic imaging
Hip Joint / diagnostic imaging
Humans
Middle Aged
Osteotomy / methods
Retrospective Studies