Rationale and Objectives
To investigate the relationship between upper-thigh intermuscular fat, subcutaneous
fat measured by CT and major complications after primary total hip arthroplasty (THA).
Materials and Methods
Between 2015 and 2021, consecutive patients who had primary THA and preoperative hip
CT were retrospectively included. Upper-thigh muscle cross-sectional intermuscular
fat, subcutaneous fat, and muscle area were measured on hip CT images. The major complications
included dislocation, aseptic loosening, infection, and periprosthetic fracture. The
effect of upper-thigh intermuscular fat, subcutaneous fat and muscle area on the outcome
was analyzed using multivariable cox proportional hazards analysis. Adjusted hazard
ratios (HRs) and 95% confidence intervals (CIs) were calculated.
Results
A total of 3028 patients were included and 71 (2.34%) of them had major complications.
During a median of 25 months of follow-up, patients showed increased incidence of
total major complications with increased intermuscular fat area (log-rank p = 0.012). The multivariable cox regression revealed that per SD increment in intermuscular
fat area was associated with higher risk of total major complications (HR = 2.04,
95% CI = 1.71–2.43, p < 0.001), dislocation (HR = 1.96, 95% CI = 1.44–2.66, p < 0.001), aseptic loosening (HR = 2.02, 95% CI = 1.30–3.16, p = 0.002), infection (HR = 1.94, 95% CI = 1.24–3.05, p = 0.004), and periprosthetic fracture (HR = 2.26, 95% CI = 1.67-3.07, p < 0.001).
Conclusion
Upper-thigh intermuscular fat, but not subcutaneous fat measured on CT associated
with the risk of major complications after primary THA.
Key Words
Abbreviations:
BMI (body mass index), CAD (coronary artery disease), CI (confidence interval), DM (diabetes mellitus), HR (hazard ratio), ICC (intraclass correlation coefficient), IMF (intermuscular fat), SCF (subcutaneous fat), SD (standard deviation), THA (total hip arthroplasty)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 15, 2022
Accepted:
September 16,
2022
Received in revised form:
September 13,
2022
Received:
August 31,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of The Association of University Radiologists.
