Magnetic Resonance Imaging Assessment of Hip Abductor after Total Hip Arthroplasty Using a Direct Lateral Approach



1 Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran

2 Department of Orthopedic Surgery, Taleghani Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran

3 Department of Orthopedic Surgery, Akhtar Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran


Background: Surgical techniques and rehabilitations after total hip arthroplasty (THA) play a significant role in the
improvement of pain and limping. This study aimed to assess hip abductor muscle’s diameter and its strength after 6
months postoperative THA performed by Hardinge approach.
Methods: After obtaining the patients’ demographic characteristics, the preoperative values of patients’ hip abductor
muscle diameter were measured using magnetic resonance imaging, and were compared with postoperative values 6
months later. Moreover, the hip abductor muscle’s strength was assessed using the Trendelenburg test.
Results: A total of 88 patients participated in this study with a mean age of 47.3±1.574 years. It should be noted that
55.7% of the participants were male. Muscle diameter decreased from a mean value of 27.07±7.485 preoperative to
mean value of 25.64±7.353 mm postoperative (P<0.001). Moreover, the degrees of Trendelenburg test (i.e., mild or
severe) decreased after surgery (P<0.001). There was no significant difference between the frequencies of different
grades of limping according to the studied variables.
Conclusion: A decrease was observed in gluteus medius muscle diameter, and the Trendelenburg test results were
improved in this study. Moreover, the difference between pre- and postoperative gluteus medius muscle diameters were
measured using MRI. It can be concluded that MRI is not an appropriate diagnostic tool for the assessment of abductor
strength after THA in the 6-month postoperative visit. Accordingly, it is suggested to evaluate muscle strength before
and after each surgery to schedule the following treatment protocol required for each patient.
Level of evidence: IV


Main Subjects