title: Surgical hip dislocation does not result in atrophy or fatty infiltration of periarticular hip muscles.
abstract: Surgical hip dislocation is the gold standard for treatment of femoroacetabular impingement (FAI). It utilizes an intermuscular and internervous approach to the hip. Concerns have been expressed that this approach causes soft tissue trauma resulting in post-operative muscle weakness of patients undergoing this procedure. We therefore asked whether surgical hip dislocation leads to (i) atrophy (decreased muscle diameter or cross-sectional area [CSA]) and (ii) degeneration (fatty infiltration) of 18 evaluated periarticular hip muscles. We retrospectively evaluated 32 patients (34 hips) following surgical hip dislocation for the treatment of FAI using pre and post-operative magnetic resonance (MR) arthrography of the hip. We evaluated muscle diameter, CSA and degree of fatty infiltration according to Goutallier for 18 periarticular hip muscles on axial and sagittal views. The mean interval between pre and post-operative MR was 1.9 ± 1.5 years (range, 0.4-6.1 years). Pre and post-operative muscle diameter and CSA of all 18 evaluated hip muscles did not differ. There was no post-operative change in the Goutallier classification for any of the evaluated 18 muscles. No muscle had post-operative degeneration higher than Grade 1 according to Goutallier. No atrophy or degeneration of periarticular hip muscles could be found following surgical hip dislocation for treatment of FAI. Any raised concerns about the invasiveness and potential muscle trauma for this type of surgery are unfounded. Level III, retrospective comparative study. See guidelines for authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, 3010 Bern, Switzerland and Department of Orthopaedic Surgery, Waterford Regional Hospital, Waterford, Ireland.
authors.forename: Aaron A
authors.initials: AA
authors.lastname: Glynn
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, 3010 Bern, Switzerland and Department of Orthopaedic Surgery, Waterford Regional Hospital, Waterford, Ireland.
authors.forename: Fabio Y
authors.initials: FY
authors.lastname: Barattiero
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, 3010 Bern, Switzerland and Department of Orthopaedic Surgery, Waterford Regional Hospital, Waterford, Ireland.
authors.forename: Christoph E
authors.initials: CE
authors.lastname: Albers
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, 3010 Bern, Switzerland and Department of Orthopaedic Surgery, Waterford Regional Hospital, Waterford, Ireland.
authors.forename: Markus S
authors.initials: MS
authors.lastname: Hanke
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, 3010 Bern, Switzerland and Department of Orthopaedic Surgery, Waterford Regional Hospital, Waterford, Ireland.
authors.forename: Simon D
authors.initials: SD
authors.lastname: Steppacher
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, 3010 Bern, Switzerland and Department of Orthopaedic Surgery, Waterford Regional Hospital, Waterford, Ireland.
authors.forename: Moritz
authors.initials: M
authors.lastname: Tannast