Association of preoperative hip muscle quality with functional outcomes after total hip arthroplasty

doi:10.3877/cma.j.issn.1674-134X.2026.02.005

Abstract

Abstract:

Objective

To identify preoperative muscle compositions of operated and contralateral sides and examine the association with postoperative walking and chair-raising outcomes after unilateral total hip arthroplasty (THA).

Methods

This retrospective study included 305 patients who underwent unilateral primary THA due to femoral head necrosis or hip osteoarthritis from January 2022 to December 2023. Exclusion criteria were: a history of long-term bedridden, prior hip surgery history on the operative side, hip dysplasia, severe complications after THA, incomplete imaging or functional data. A total of 133 patients were included in this study. Bilateral total muscle area index (TMI), normal attenuation muscle area index (NAMI) and fat infiltration (FI) of hip muscles were examined on a preoperative axial CT image. Six-meter walking test (6mWT) and five times sit-to-stand test (5-STST) were conducted at three-month follow-up. Paired t test or Wilcoxon rank sum test were used to compare the differences between bilateral muscle compositions. Pearson correlation coefficients were calculated to determine the factors associated with 6mWT and 5-STST results. Factors with P<0.1 in the univariate analysis were included in multivariate linear regression analysis.

Results

Preoperatively, TMI was significantly higher on the contralateral side of gluteus maximus (t=-10.700, P<0.001), gluteus medius (Z=-3.407, P=0.001), iliopsoas (t=-6.839, P<0.001), and rectus femoris (t=-6.327, P<0.001) compared with the operative side. In terms of muscle quality, NAMI was significantly higher and FI was significantly lower on the contralateral side of gluteus maximus (NAMI: t=-12.359, P<0.001, FI: Z=-8.774, P<0.001), gluteus medius (NAMI: t=-8.213, P<0.001, FI: Z=-8.241, P<0.001), gluteus minimus (NAMI: t=-5.110, P<0.001, FI: Z=-7.063, P<0.001), iliopsoas (NAMI: t=-9.010, P<0.001, FI: Z=-7.587, P<0.001), piriformis (NAMI: Z=-5.841, P<0.001, FI: Z=-6.569, P<0.001), and rectus femoris (NAMI: t=-6.835, P<0.001, FI: Z=-4.500, P<0.001) compared with the operative side. In multivariate regression analysis, age (B=0.123, P<0.001) and contralateral gluteus minimus FI (B=5.948, P=0.013) were independently positively associated with 5-STST time. Contralateral gluteus maximus TMI (B=-0.438, P=0.001) was independently negatively associated with 5-STST time. Age (B=-0.006, P<0.001) and contralateral iliopsoas FI (B=-1.178, P<0.001) were independently negatively associated with 6mWT speed. Contralateral gluteus minimus TMI (B=0.047, P=0.025) was independently positively associated with 6mWT speed.

Conclusion

The preoperative muscle qualities of gluteus maximus, gluteus minimus and iliopsoas on the non-operative side were significantly associated with postoperative gait and sit-to-stand abilities at the three-month follow-up.

Key words: Hip joint, Muscular atrophy, Arthroplasty, replacement, hip, Rehabilitation

Zhengyuan Bao, Hung-Kang Tsai, Can Cui, Wing-Hoi Cheung, Qing Jiang, Zhihong Xu. Association of preoperative hip muscle quality with functional outcomes after total hip arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2026, 20(02): 164-173.

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URL: https://zhgjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-134X.2026.02.005

https://zhgjwkzz.cma-cmc.com.cn/EN/Y2026/V20/I02/164

Figures/Tables 6

Figure 1 Diagram of the postoperative discrepancy of leg length, acetabular offset and femoral offset on the anteroposterior pelvic image Note: distance A is measured as the perpendicular distance from the most medial tip of the lesser trochanter to the trans-teardrop line on the operative side, while distance a is measured using the same method on the contralateral side, the difference between them is defined as length difference of bilateral lower limbs; acetabular offset B was measured as the perpendicular distance from the femoral head rotation center to the vertical trans-teardrop line on the operative side, while distance b is measured using the same method on the contralateral side, the difference between them is defined as difference in acetabular offset ; femoral offset C on the operative side is defined as the distance from the femoral head rotation center to the anatomic axis of the proximal femur, while distance c is measured using the same method on the contralateral side, the difference between them is defined as difference in femoral offset

Figure 2 Muscle quality map of bilateral gluteus maximus, gluteus medius, gluteus minimus, iliopsoas, piriformis and rectus femoris muscles on the preoperative axial CT image of pelvis. A and B are gluteus maximus, gluteus medius, gluteus minimus, iliopsoas, and piriformis at the level of the anterior inferior spine; C and D are rectus femoris at the level of the lesser trochanter Note: green is normal attenuation muscle area; blue is low attenuation muscle area; purple is intramuscular adipose area

Table 1 Muscle quality comparisons between the operative and contralateral sides before surgery

参数 Parameters		术侧 Operative side	对侧 Contralateral side	统计值 Statistical values	P值
臀大肌 Gluteus maximus	TMI ［cm²/m²，（ $x ¯$ ±s）］	11.2±2.9	13.7±3.2	t=-10.700	<0.001
	NAMI ［cm²/m²，（ $x ¯$ ±s）］	5.9±3.3	9.4±3.7	t=-12.359	<0.001
	FI ［%，M（P₂₅，P₇₅）］	46.9（30.5，66.7）	28.5（18.2，44.1）	Z=-8.774	<0.001
臀中肌 Gluteus medius	TMI ［cm²/m²，M（P₂₅，P₇₅）］	7.0（5.6，8.2）	7.3（6.2，8.8）	Z=-3.407	0.001
	NAMI ［cm²/m²，（ $x ¯$ ±s）］	4.6±2.0	6.1±2.0	t=-8.213	<0.001
	FI ［%，M（P₂₅，P₇₅）］	34.3（21.1，45.9）	17.5（11.7，26.7）	z=-8.241	<0.001
臀小肌 Gluteus minimus	TMI ［cm²/m²，（ $x ¯$ ±s）］	4.6±1.3	4.6±1.0	t=-0.066	>0.05
	NAMI ［cm²/m²，（ $x ¯$ ±s）］	3.0±1.3	3.7±1.2	t=-5.110	<0.001
	FI ［%，M（P₂₅，P₇₅）］	30.1（20.3，45.5）	15.5（9.9，27.8）	Z=-7.063	<0.001
髂腰肌 Iliopsoas	TMI ［cm²/m²，（ $x ¯$ ±s）］	3.1±0.8	3.5±0.9	t=-6.839	<0.001
	NAMI ［cm²/m²，（ $x ¯$ ±s）］	2.6±0.9	3.3±0.9	t=-9.010	<0.001
	FI ［%，M（P₂₅，P₇₅）］	12.8（7.7，20.1）	7.1（3.9，12.0）	Z=-7.587	<0.001
梨状肌 Piriformis	TMI ［cm²/m²，M（P₂₅，P₇₅）］	2.8（2.1，3.5）	2.9（2.2，3.9）	Z=-1.559	>0.05
	NAMI ［cm²/m²，M（P₂₅，P₇₅）］	1.3（0.5，2.3）	1.7（0.8，3.1）	Z=-5.841	<0.001
	FI ［%，M（P₂₅，P₇₅）］	55.8（33.1，77.6）	39.0（21.3，62.9）	Z=-6.569	<0.001
股直肌 Rectus femoris	TMI ［cm²/m²，（ $x ¯$ ±s）］	1.9±0.6	2.1±0.6	t=-6.327	<0.001
	NAMI ［cm²/m²，（ $x ¯$ ±s）］	1.7±0.6	2.0±0.6	t=-6.835	<0.001
	FI ［%，M（P₂₅，P₇₅）］	6.7（3.5，14.3）	4.2（2.1，6.6）	Z=-4.500	<0.001

Table 1 Muscle quality comparisons between the operative and contralateral sides before surgery

参数 Parameters		术侧 Operative side	对侧 Contralateral side	统计值 Statistical values	P值
臀大肌 Gluteus maximus	TMI ［cm²/m²，（ $x ¯$ ±s）］	11.2±2.9	13.7±3.2	t=-10.700	<0.001
	NAMI ［cm²/m²，（ $x ¯$ ±s）］	5.9±3.3	9.4±3.7	t=-12.359	<0.001
	FI ［%，M（P₂₅，P₇₅）］	46.9（30.5，66.7）	28.5（18.2，44.1）	Z=-8.774	<0.001
臀中肌 Gluteus medius	TMI ［cm²/m²，M（P₂₅，P₇₅）］	7.0（5.6，8.2）	7.3（6.2，8.8）	Z=-3.407	0.001
	NAMI ［cm²/m²，（ $x ¯$ ±s）］	4.6±2.0	6.1±2.0	t=-8.213	<0.001
	FI ［%，M（P₂₅，P₇₅）］	34.3（21.1，45.9）	17.5（11.7，26.7）	z=-8.241	<0.001
臀小肌 Gluteus minimus	TMI ［cm²/m²，（ $x ¯$ ±s）］	4.6±1.3	4.6±1.0	t=-0.066	>0.05
	NAMI ［cm²/m²，（ $x ¯$ ±s）］	3.0±1.3	3.7±1.2	t=-5.110	<0.001
	FI ［%，M（P₂₅，P₇₅）］	30.1（20.3，45.5）	15.5（9.9，27.8）	Z=-7.063	<0.001
髂腰肌 Iliopsoas	TMI ［cm²/m²，（ $x ¯$ ±s）］	3.1±0.8	3.5±0.9	t=-6.839	<0.001
	NAMI ［cm²/m²，（ $x ¯$ ±s）］	2.6±0.9	3.3±0.9	t=-9.010	<0.001
	FI ［%，M（P₂₅，P₇₅）］	12.8（7.7，20.1）	7.1（3.9，12.0）	Z=-7.587	<0.001
梨状肌 Piriformis	TMI ［cm²/m²，M（P₂₅，P₇₅）］	2.8（2.1，3.5）	2.9（2.2，3.9）	Z=-1.559	>0.05
	NAMI ［cm²/m²，M（P₂₅，P₇₅）］	1.3（0.5，2.3）	1.7（0.8，3.1）	Z=-5.841	<0.001
	FI ［%，M（P₂₅，P₇₅）］	55.8（33.1，77.6）	39.0（21.3，62.9）	Z=-6.569	<0.001
股直肌 Rectus femoris	TMI ［cm²/m²，（ $x ¯$ ±s）］	1.9±0.6	2.1±0.6	t=-6.327	<0.001
	NAMI ［cm²/m²，（ $x ¯$ ±s）］	1.7±0.6	2.0±0.6	t=-6.835	<0.001
	FI ［%，M（P₂₅，P₇₅）］	6.7（3.5，14.3）	4.2（2.1，6.6）	Z=-4.500	<0.001

Table 2 Univariate analysis on time of five times sit-to-stand test and six-meter walking speed after surgery

变量 Variations		5次坐立时间 Five times sit-to-stand time		6 m行走步速 Six-meter walking speed
变量 Variations		r值	P值	r值	P值
年龄Age		0.295	0.001	-0.287	0.001
性别Gender		0.083	>0.05	-0.149	>0.05
身体质量指数 Body mass index		-0.101	>0.05	0.008	>0.05
下肢长度差异 Limb length discrepancy		0.064	>0.05	-0.008	>0.05
髋臼偏心距差异 Acetabular offset discrepancy		-0.050	>0.05	0.043	>0.05
股骨偏心距差异 Femoral offset discrepancy		0.084	>0.05	0.002	>0.05
术侧 Operative side
臀大肌 Gluteus maximus	TMI	-0.022	>0.05	-0.169	>0.05
	NAMI	0.029	>0.05	-0.057	>0.05
	FI	-0.033	>0.05	-0.033	>0.05
臀中肌 Gluteus medius	TMI	0.002	>0.05	-0.008	>0.05
	NAMI	0.028	>0.05	0.003	>0.05
	FI	-0.016	>0.05	-0.037	>0.05
臀小肌 Gluteus minimus	TMI	-0.036	>0.05	-0.007	>0.05
	NAMI	-0.046	>0.05	0.016	>0.05
	FI	0.019	>0.05	-0.003	>0.05
髂腰肌 Iliopsoas	TMI	-0.008	>0.05	0.059	>0.05
	NAMI	-0.060	>0.05	0.146	>0.05
	FI	0.103	>0.05	-0.195	0.024
梨状肌 Piriformis	TMI	-0.003	>0.05	0.076	>0.05
	NAMI	0.012	>0.05	0.153	>0.05
	FI	-0.066	>0.05	-0.138	>0.05
股直肌 Rectus femoris	TMI	-0.268	0.008	0.228	0.024
	NAMI	-0.265	0.008	0.233	0.021
	FI	0.106	>0.05	-0.107	>0.05
对侧 Contralateral side
臀大肌 Gluteus maximus	TMI	-0.310	<0.001	0.156	>0.05
	NAMI	-0.315	<0.001	0.257	0.003
	FI	0.173	0.046	-0.223	0.010
臀中肌 Gluteus medius	TMI	-0.001	>0.05	0.006	>0.05
	NAMI	-0.097	>0.05	0.085	>0.05
	FI	0.188	0.030	-0.173	0.047
臀小肌 Gluteus minimus	TMI	-0.193	0.026	0.180	0.038
	NAMI	-0.326	<0.001	0.286	0.001
	FI	0.328	<0.001	-0.276	0.001
髂腰肌 Iliopsoas	TMI	-0.163	>0.05	0.097	>0.05
	NAMI	-0.207	0.017	0.177	0.041
	FI	0.213	0.014	-0.336	<0.001
梨状肌 Piriformis	TMI	-0.103	>0.05	0.062	>0.05
	NAMI	-0.109	>0.05	0.093	>0.05
	FI	0.063	>0.05	-0.125	>0.05
股直肌 Rectus femoris	TMI	-0.338	0.001	0.195	0.055
	NAMI	-0.349	<0.001	0.231	0.022
	FI	0.185	>0.05	-0.217	0.032

Table 2 Univariate analysis on time of five times sit-to-stand test and six-meter walking speed after surgery

变量 Variations		5次坐立时间 Five times sit-to-stand time		6 m行走步速 Six-meter walking speed
变量 Variations		r值	P值	r值	P值
年龄Age		0.295	0.001	-0.287	0.001
性别Gender		0.083	>0.05	-0.149	>0.05
身体质量指数 Body mass index		-0.101	>0.05	0.008	>0.05
下肢长度差异 Limb length discrepancy		0.064	>0.05	-0.008	>0.05
髋臼偏心距差异 Acetabular offset discrepancy		-0.050	>0.05	0.043	>0.05
股骨偏心距差异 Femoral offset discrepancy		0.084	>0.05	0.002	>0.05
术侧 Operative side
臀大肌 Gluteus maximus	TMI	-0.022	>0.05	-0.169	>0.05
	NAMI	0.029	>0.05	-0.057	>0.05
	FI	-0.033	>0.05	-0.033	>0.05
臀中肌 Gluteus medius	TMI	0.002	>0.05	-0.008	>0.05
	NAMI	0.028	>0.05	0.003	>0.05
	FI	-0.016	>0.05	-0.037	>0.05
臀小肌 Gluteus minimus	TMI	-0.036	>0.05	-0.007	>0.05
	NAMI	-0.046	>0.05	0.016	>0.05
	FI	0.019	>0.05	-0.003	>0.05
髂腰肌 Iliopsoas	TMI	-0.008	>0.05	0.059	>0.05
	NAMI	-0.060	>0.05	0.146	>0.05
	FI	0.103	>0.05	-0.195	0.024
梨状肌 Piriformis	TMI	-0.003	>0.05	0.076	>0.05
	NAMI	0.012	>0.05	0.153	>0.05
	FI	-0.066	>0.05	-0.138	>0.05
股直肌 Rectus femoris	TMI	-0.268	0.008	0.228	0.024
	NAMI	-0.265	0.008	0.233	0.021
	FI	0.106	>0.05	-0.107	>0.05
对侧 Contralateral side
臀大肌 Gluteus maximus	TMI	-0.310	<0.001	0.156	>0.05
	NAMI	-0.315	<0.001	0.257	0.003
	FI	0.173	0.046	-0.223	0.010
臀中肌 Gluteus medius	TMI	-0.001	>0.05	0.006	>0.05
	NAMI	-0.097	>0.05	0.085	>0.05
	FI	0.188	0.030	-0.173	0.047
臀小肌 Gluteus minimus	TMI	-0.193	0.026	0.180	0.038
	NAMI	-0.326	<0.001	0.286	0.001
	FI	0.328	<0.001	-0.276	0.001
髂腰肌 Iliopsoas	TMI	-0.163	>0.05	0.097	>0.05
	NAMI	-0.207	0.017	0.177	0.041
	FI	0.213	0.014	-0.336	<0.001
梨状肌 Piriformis	TMI	-0.103	>0.05	0.062	>0.05
	NAMI	-0.109	>0.05	0.093	>0.05
	FI	0.063	>0.05	-0.125	>0.05
股直肌 Rectus femoris	TMI	-0.338	0.001	0.195	0.055
	NAMI	-0.349	<0.001	0.231	0.022
	FI	0.185	>0.05	-0.217	0.032

Table 3 Multivariate linear regression analyses on time of five times sit-to-stand test and six-meter walking speed after surgery

模型 Model		模型P值 Model P value	R²	调整R² Adjusted R²	B	95% CI	P值	VIF
5次坐立时间 Five times sit-to-stand test time	常量 Constant	<0.001	0.261	0.237	13.057	（7.661，18.451）	<0.001	-
	年龄 Age				0.123	（0.053，0.193）	<0.001	1.035
	对侧臀大肌TMI Contralateral gluteus maximus TMI				-0.438	（-0.701，-0.176）	0.001	1.060
	对侧臀小肌FI Contralateral gluteus minimus FI				5.948	（1.272，10.624）	0.013	1.056
模型 Model		模型P值 Model P value	R²	调整R² Adjusted R²	B	95% CI	P值	VIF
6 m行走步速 Six-meter walking speed	常量 Constant	<0.001	0.230	0.205	1.156	（0.858，1.454）	<0.001	-
	年龄 Age				-0.006	（-0.010，-0.003）	<0.001	1.001
	对侧臀小肌TMI Contralateral gluteus minimus TMI				0.047	（0.006，0.088）	0.025	1.001
	对侧髂腰肌FI Contralateral iliopsoas FI				-1.178	（-1.864，-0.491）	<0.001	1.001

Table 4 Intra- and interobserver reliability

影响因素 Factors		观察者内 Intraobserver		观察者间 Interobserver
影响因素 Factors		ICC	95%CI	ICC	95%CI
下肢长度差异 Limb length discrepancy		0.978	（0.915，0.995）	0.902	（0.770，0.960）
髋臼偏心距差异 Acetabular offset discrepancy		0.990	（0.962，0.998）	0.930	（0.833，0.972）
股骨偏心距差异 Femoral offset discrepancy		0.988	（0.953，0.969）	0.924	（0.818，0.969）
术侧肌肉成分 Muscle composition on the operative side
臀大肌 Gluteus maximus	NAMA	0.987	（0.948，0.997）	0.985	（0.940，0.996）
	LAMA	0.968	（0.876，0.992）	0.961	（0.851，0.990）
	IMAA	0.937	（0.769，0.984）	0.904	（0.661，0.975）
臀中肌 Gluteus medius	NAMA	0.981	（0.925，0.995）	0.979	（0.918，0.995）
	LAMA	0.943	（0.790，0.986）	0.930	（0.745，0.982）
	IMAA	0.930	（0.746，0.982）	0.917	（0.704，0.979）
臀小肌 Gluteus minimus	NAMA	0.969	（0.881，0.992）	0.963	（0.859，0.991）
	LAMA	0.958	（0.842，0.989）	0.953	（0.824，0.988）
	IMAA	0.923	（0.721，0.980）	0.912	（0.689，0.978）
髂腰肌 Iliopsoas	NAMA	0.947	（0.801，0.986）	0.956	（0.835，0.989）
	LAMA	0.950	（0.812，0.987）	0.921	（0.715，0.980）
	IMAA	0.927	（0.735，0.981）	0.926	（0.733，0.981）
梨状肌 Piriformis	NAMA	0.994	（0.975，0.998）	0.991	（0.963，0.998）
	LAMA	0.947	（0.804，0.987）	0.956	（0.836，0.989）
	IMAA	0.925	（0.729，0.981）	0.906	（0.670，0.976）
股直肌 Rectus femoris	NAMA	0.997	（0.988，0.999）	0.977	（0.910，0.994）
	LAMA	0.979	（0.918，0.995）	0.966	（0.870，0.991）
	IMAA	0.988	（0.951，0.997）	0.966	（0.869，0.991）
对侧肌肉成分 Muscle composition on the non-operative side
臀大肌 Gluteus maximus	NAMA	0.991	（0.964，0.998）	0.985	（0.943，0.996）
	LAMA	0.993	（0.971，0.998）	0.982	（0.928，0.995）
	IMAA	0.976	（0.908，0.994）	0.959	（0.843，0.990）
臀中肌 Gluteus medius	NAMA	0.957	（0.838，0.989）	0.944	（0.793，0.986）
	LAMA	0.949	（0.809，0.987）	0.931	（0.747，0.982）
	IMAA	0.939	（0.775，0.984）	0.911	（0.685，0.977）
臀小肌 Gluteus minimus	NAMA	0.963	（0.860，0.991）	0.957	（0.837，0.989）
	LAMA	0.965	（0.866，0.991）	0.935	（0.761，0.983）
	IMAA	0.940	（0.777，0.985）	0.909	（0.677，0.976）
髂腰肌 Iliopsoas	NAMA	0.974	（0.901，0.994）	0.975	（0.904，0.994）
	LAMA	0.974	（0.901，0.994）	0.935	（0.762，0.983）
	IMAA	0.943	（0.787，0.985）	0.936	（0.764，0.984）
梨状肌 Piriformis	NAMA	0.981	（0.925，0.995）	0.975	（0.903，0.994）
	LAMA	0.989	（0.955，0.997）	0.954	（0.825，0.988）
	IMAA	0.942	（0.785，0.985）	0.910	（0.681，0.977）
股直肌 Rectus femoris	NAMA	0.986	（0.943，0.996）	0.961	（0.852，0.990）
	LAMA	0.989	（0.957，0.997）	0.952	（0.819，0.988）
	IMAA	0.966	（0.870，0.991）	0.956	（0.833，0.989）

Table 4 Intra- and interobserver reliability

影响因素 Factors		观察者内 Intraobserver		观察者间 Interobserver
影响因素 Factors		ICC	95%CI	ICC	95%CI
下肢长度差异 Limb length discrepancy		0.978	（0.915，0.995）	0.902	（0.770，0.960）
髋臼偏心距差异 Acetabular offset discrepancy		0.990	（0.962，0.998）	0.930	（0.833，0.972）
股骨偏心距差异 Femoral offset discrepancy		0.988	（0.953，0.969）	0.924	（0.818，0.969）
术侧肌肉成分 Muscle composition on the operative side
臀大肌 Gluteus maximus	NAMA	0.987	（0.948，0.997）	0.985	（0.940，0.996）
	LAMA	0.968	（0.876，0.992）	0.961	（0.851，0.990）
	IMAA	0.937	（0.769，0.984）	0.904	（0.661，0.975）
臀中肌 Gluteus medius	NAMA	0.981	（0.925，0.995）	0.979	（0.918，0.995）
	LAMA	0.943	（0.790，0.986）	0.930	（0.745，0.982）
	IMAA	0.930	（0.746，0.982）	0.917	（0.704，0.979）
臀小肌 Gluteus minimus	NAMA	0.969	（0.881，0.992）	0.963	（0.859，0.991）
	LAMA	0.958	（0.842，0.989）	0.953	（0.824，0.988）
	IMAA	0.923	（0.721，0.980）	0.912	（0.689，0.978）
髂腰肌 Iliopsoas	NAMA	0.947	（0.801，0.986）	0.956	（0.835，0.989）
	LAMA	0.950	（0.812，0.987）	0.921	（0.715，0.980）
	IMAA	0.927	（0.735，0.981）	0.926	（0.733，0.981）
梨状肌 Piriformis	NAMA	0.994	（0.975，0.998）	0.991	（0.963，0.998）
	LAMA	0.947	（0.804，0.987）	0.956	（0.836，0.989）
	IMAA	0.925	（0.729，0.981）	0.906	（0.670，0.976）
股直肌 Rectus femoris	NAMA	0.997	（0.988，0.999）	0.977	（0.910，0.994）
	LAMA	0.979	（0.918，0.995）	0.966	（0.870，0.991）
	IMAA	0.988	（0.951，0.997）	0.966	（0.869，0.991）
对侧肌肉成分 Muscle composition on the non-operative side
臀大肌 Gluteus maximus	NAMA	0.991	（0.964，0.998）	0.985	（0.943，0.996）
	LAMA	0.993	（0.971，0.998）	0.982	（0.928，0.995）
	IMAA	0.976	（0.908，0.994）	0.959	（0.843，0.990）
臀中肌 Gluteus medius	NAMA	0.957	（0.838，0.989）	0.944	（0.793，0.986）
	LAMA	0.949	（0.809，0.987）	0.931	（0.747，0.982）
	IMAA	0.939	（0.775，0.984）	0.911	（0.685，0.977）
臀小肌 Gluteus minimus	NAMA	0.963	（0.860，0.991）	0.957	（0.837，0.989）
	LAMA	0.965	（0.866，0.991）	0.935	（0.761，0.983）
	IMAA	0.940	（0.777，0.985）	0.909	（0.677，0.976）
髂腰肌 Iliopsoas	NAMA	0.974	（0.901，0.994）	0.975	（0.904，0.994）
	LAMA	0.974	（0.901，0.994）	0.935	（0.762，0.983）
	IMAA	0.943	（0.787，0.985）	0.936	（0.764，0.984）
梨状肌 Piriformis	NAMA	0.981	（0.925，0.995）	0.975	（0.903，0.994）
	LAMA	0.989	（0.955，0.997）	0.954	（0.825，0.988）
	IMAA	0.942	（0.785，0.985）	0.910	（0.681，0.977）
股直肌 Rectus femoris	NAMA	0.986	（0.943，0.996）	0.961	（0.852，0.990）
	LAMA	0.989	（0.957，0.997）	0.952	（0.819，0.988）
	IMAA	0.966	（0.870，0.991）	0.956	（0.833，0.989）

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