Evaluation of Stiffness in the Tensor Fascia Latae and Iliotibial Band after Total Hip Arthroplasty

Purpose This study aimed to postoperative changes in stiffness of the tensor fascia latae (TFL) and iliotibial band (ITB) after total hip arthroplasty (THA) via the direct anterior approach. The association between changes in hip alignment, pain, and hip range of motion (ROM) was also investigated. Methods Forty-eight patients (64 hips) undergoing primary THA from April to November 2023 were included. Shear wave elastography (SWE) was used to measure TFL and ITB stiffness preoperatively and daily during the first postoperative week. Changes over time were analyzed, and correlations between femoral offset (FO), leg length, pain during gait, and hip ROM were assessed. Results Shear wave elastography values of the TFL and ITB were significantly higher postoperatively compared to those at preoperation ( P  < .05). Change in FO correlated with SWE values of the TFL and ITB on postoperative day one ( P  < .05). The SWE values of the TFL and ITB correlated with pain during gait on postoperative day 2–7 ( P  < .05), and were negatively correlated with ROM of hip adduction and extension ( P  < .05). Conclusions Early postoperative TFL and ITB stiffness increased postoperatively compared to those at preoperation, and postoperative TFL and ITB stiffness correlated with changes in FO, pain during gait, hip adduction, and extension ROM.