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Targeting of Periprosthetic Muscles for the Ultrasonographic Screening of Hip Abnormalities in Hip Resurfacing Arthroplasty Patients

Background: Hip resurfacing arthroplasty (HRA) patients require subsequent annual screening for postoperative complications. Ultrasonography may be useful for this purpose but lacks a screening protocol for hips. The purpose of this study was to evaluate the accuracy of ultrasonography for detecting...

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Autores principales: Choe, Hyonmin, Kobayashi, Naomi, Abe, Koki, Hieda, Yuta, Ike, Hiroyuki, Kumagai, Ken, Miyatake, Kazuma, Fujisawa, Takahiro, Inaba, Yutaka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146634/
https://www.ncbi.nlm.nih.gov/pubmed/37109208
http://dx.doi.org/10.3390/jcm12082871
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author Choe, Hyonmin
Kobayashi, Naomi
Abe, Koki
Hieda, Yuta
Ike, Hiroyuki
Kumagai, Ken
Miyatake, Kazuma
Fujisawa, Takahiro
Inaba, Yutaka
author_facet Choe, Hyonmin
Kobayashi, Naomi
Abe, Koki
Hieda, Yuta
Ike, Hiroyuki
Kumagai, Ken
Miyatake, Kazuma
Fujisawa, Takahiro
Inaba, Yutaka
author_sort Choe, Hyonmin
collection PubMed
description Background: Hip resurfacing arthroplasty (HRA) patients require subsequent annual screening for postoperative complications. Ultrasonography may be useful for this purpose but lacks a screening protocol for hips. The purpose of this study was to evaluate the accuracy of ultrasonography for detecting postoperative complications in HRA patients using a screening protocol that specifically targets periprosthetic muscles. Methods: We enrolled 45 hips from 40 HRA patients with a mean follow-up period of 8.2 years. MRI and ultrasonography scans were simultaneously conducted at follow-up. The ultrasonography assessments were conducted on the anterior part of the hip that targets iliopsoas, sartorius, rectus femoris, lateral with anterior superior and inferior iliac spine (ASIS and AIIS) as bony landmarks, and the lateral and posterior parts that target fascia tensor, short rotators, and gluteus minimus, medius, and maximus with greater trochanter and ischial tuberosity as bony landmarks. The accuracy of diagnosing postoperative abnormalities and the visibility of periprosthetic muscles were compared between these two modalities. Results: Both MRI and ultrasonography detected an abnormal region in eight cases comprising two infections, two pseudotumors, and four patients with greater trochanteric bursitis. Among these cases, four hips required implant removal. The increase in anterior space, measured as the distance between the iliopsoas and resurfacing head, was a good indicator for the abnormal mass in these four HRA cases. In the assessment of periprosthetic muscles, MRI showed a much lower visibility than ultrasonography in the iliopsoas (6.7% vs. 100%), gluteus minimus (6.7% vs. 88.9%), and short rotators (8.8% vs. 71.4%) due to implant halation. Conclusions: By targeting periprosthetic muscles, ultrasonography can detect postoperative complications as effectively as MRI assessments in HRA patients. Ultrasonography has superior visibility in the periprosthetic muscles of HRA patients, indicating its utility for the screening of small legions in these cases which may not be visible by MRI.
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spelling pubmed-101466342023-04-29 Targeting of Periprosthetic Muscles for the Ultrasonographic Screening of Hip Abnormalities in Hip Resurfacing Arthroplasty Patients Choe, Hyonmin Kobayashi, Naomi Abe, Koki Hieda, Yuta Ike, Hiroyuki Kumagai, Ken Miyatake, Kazuma Fujisawa, Takahiro Inaba, Yutaka J Clin Med Article Background: Hip resurfacing arthroplasty (HRA) patients require subsequent annual screening for postoperative complications. Ultrasonography may be useful for this purpose but lacks a screening protocol for hips. The purpose of this study was to evaluate the accuracy of ultrasonography for detecting postoperative complications in HRA patients using a screening protocol that specifically targets periprosthetic muscles. Methods: We enrolled 45 hips from 40 HRA patients with a mean follow-up period of 8.2 years. MRI and ultrasonography scans were simultaneously conducted at follow-up. The ultrasonography assessments were conducted on the anterior part of the hip that targets iliopsoas, sartorius, rectus femoris, lateral with anterior superior and inferior iliac spine (ASIS and AIIS) as bony landmarks, and the lateral and posterior parts that target fascia tensor, short rotators, and gluteus minimus, medius, and maximus with greater trochanter and ischial tuberosity as bony landmarks. The accuracy of diagnosing postoperative abnormalities and the visibility of periprosthetic muscles were compared between these two modalities. Results: Both MRI and ultrasonography detected an abnormal region in eight cases comprising two infections, two pseudotumors, and four patients with greater trochanteric bursitis. Among these cases, four hips required implant removal. The increase in anterior space, measured as the distance between the iliopsoas and resurfacing head, was a good indicator for the abnormal mass in these four HRA cases. In the assessment of periprosthetic muscles, MRI showed a much lower visibility than ultrasonography in the iliopsoas (6.7% vs. 100%), gluteus minimus (6.7% vs. 88.9%), and short rotators (8.8% vs. 71.4%) due to implant halation. Conclusions: By targeting periprosthetic muscles, ultrasonography can detect postoperative complications as effectively as MRI assessments in HRA patients. Ultrasonography has superior visibility in the periprosthetic muscles of HRA patients, indicating its utility for the screening of small legions in these cases which may not be visible by MRI. MDPI 2023-04-14 /pmc/articles/PMC10146634/ /pubmed/37109208 http://dx.doi.org/10.3390/jcm12082871 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Choe, Hyonmin
Kobayashi, Naomi
Abe, Koki
Hieda, Yuta
Ike, Hiroyuki
Kumagai, Ken
Miyatake, Kazuma
Fujisawa, Takahiro
Inaba, Yutaka
Targeting of Periprosthetic Muscles for the Ultrasonographic Screening of Hip Abnormalities in Hip Resurfacing Arthroplasty Patients
title Targeting of Periprosthetic Muscles for the Ultrasonographic Screening of Hip Abnormalities in Hip Resurfacing Arthroplasty Patients
title_full Targeting of Periprosthetic Muscles for the Ultrasonographic Screening of Hip Abnormalities in Hip Resurfacing Arthroplasty Patients
title_fullStr Targeting of Periprosthetic Muscles for the Ultrasonographic Screening of Hip Abnormalities in Hip Resurfacing Arthroplasty Patients
title_full_unstemmed Targeting of Periprosthetic Muscles for the Ultrasonographic Screening of Hip Abnormalities in Hip Resurfacing Arthroplasty Patients
title_short Targeting of Periprosthetic Muscles for the Ultrasonographic Screening of Hip Abnormalities in Hip Resurfacing Arthroplasty Patients
title_sort targeting of periprosthetic muscles for the ultrasonographic screening of hip abnormalities in hip resurfacing arthroplasty patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146634/
https://www.ncbi.nlm.nih.gov/pubmed/37109208
http://dx.doi.org/10.3390/jcm12082871
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