title: Magnetic resonance imaging features of preserved vs divided and repaired piriformis during total hip arthroplasty: a randomized controlled trial.
abstract: The aim of this study was to compare the muscle grade and bulk of the divided and repaired piriformis tendon by the standard posterior approach with the preserved tendon by a piriformis-sparing (PS) approach, in total hip arthroplasty. Twenty-two patients were randomized to either approach. Patients received preoperative and 3 months and 2 years postoperative magnetic resonance imaging scans. Patients and evaluators were blinded to allocation. There was significantly less deterioration in piriformis muscle grade (P = .029) and bulk (P = .015) in the PS group at 3 months. At 2 years, only the difference in grade remained significant (P = .001). There was no difference in Oxford hip scores. In conclusion, a PS approach avoids the marked wasting and deterioration in muscle grade that occurs postoperatively in the standard posterior approach.
authors.affiliation: Department of Pathology and Surgery, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Riaz J K
authors.initials: RJ
authors.lastname: Khan
authors.forename: Li On
authors.initials: LO
authors.lastname: Lam
authors.forename: William
authors.initials: W
authors.lastname: Breidahl
authors.forename: William G
authors.initials: WG
authors.lastname: Blakeney
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002081:Buttocks; D005260:Female; D006621:Hip Joint / Q000473:pathology / Q000502:physiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D018482:Muscle, Skeletal / Q000473:pathology* / Q000502:physiology / Q000601:surgery*; D009133:Muscular Atrophy / Q000453:epidemiology / Q000473:pathology; D015207:Osteoarthritis, Hip / Q000601:surgery; D020127:Recovery of Function / Q000502:physiology; D013710:Tendons / Q000473:pathology* / Q000502:physiology / Q000601:surgery*; D016896:Treatment Outcome