Sex-Specific Differences in Hip Muscle Cross-sectional Area and Fatty Infiltration in Patients With Femoroacetabular Impingement Syndrome

Overview

Journal Orthop J Sports Med

Specialty Orthopedics

Date 2023 Feb 6

PMID 36743730

Authors

Mirjam V Douma

Nicola C Casartelli

Reto Sutter

Michael Leunig

Nicola A Maffiuletti

Affiliations

Soon will be listed here.

Abstract

Background: Patients with femoroacetabular impingement syndrome (FAIS) show sex-specific differences in hip muscle function, hip morphology, and symptoms. Possible differences in hip muscle characteristics between men and women with FAIS are unknown.

Purpose: To compare hip muscle cross-sectional area (CSA) and fatty infiltration between men and women with FAIS and investigate possible associations with patient-reported outcomes.

Study Design: Cohort study; Level of evidence, 3.

Methods: We retrospectively analyzed preoperative axial pelvic magnetic resonance imaging scans of 104 patients (54 women) who underwent hip surgery for FAIS. The main outcome measures were side-to-side percentage asymmetry in hip muscle CSA and involved-side fatty infiltration as measured with the Goutallier scale for a total of 10 hip muscles. Patient-reported outcomes included duration of hip symptoms, iHOT-12 (12-item International Hip Outcome Tool), and Hip Sports Activity Scale.

Results: Women showed larger hip abductor muscle CSA asymmetry than men ( = .018), particularly for the gluteus medius ( = .049), while men exhibited more fatty streaks (grade 1) in the gluteus medius ( = .015) than women. Duration of symptoms was associated only with fatty infiltration of obturator externus in men ( = -0.55, = .018). iHOT-12 was associated with CSA asymmetry of the gluteus minimus ( = -0.41, = .011) and iliopsoas ( = -0.36, = .028) in men and with piriformis fatty infiltration ( = -0.56, = .030) in women. The Hip Sports Activity Scale was associated with iliopsoas CSA asymmetry ( = 0.32, = .026) and with fatty infiltration of the tensor fasciae latae ( = -0.45, = .046) and obturator externus ( = -0.50, = .023) in women.

Conclusion: Patients with FAIS demonstrated few sex-specific quantitative and qualitative alterations of hip muscles. Women showed greater hip abductor muscle atrophy than men, particularly for the gluteus medius, while men showed a higher degree of fatty infiltration in this same muscle. The duration of hip symptoms was not associated with muscle atrophy. Patient-reported hip pain/function and sport activity level were only moderately associated with isolated muscular variables.

Citing Articles

Decreased volume of rectus femoris and iliocapsularis in patients with femoroacetabular impingement syndrome after primary hip arthroscopy.

Zhu Y, Liu R, Hao Y, Tao B, Sun R, Gao G BMC Musculoskelet Disord. 2024; 25(1):841.

PMID: 39448935 PMC: 11515651. DOI: 10.1186/s12891-024-07965-2.

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