Comparing the behavior of children treated using general anesthesia with those treated using conscious sedation

The histopathologic study was performed to elucidate whether the fiber type atrophy of the vastus lateralis muscle in patients with hip or knee joint disorders is related to the activities of daily living (ADL) or habitual physical activity. Subjects were 16 female patients, 52.4 +/- 16.0 yr of age (mean +/- standard deviation), who underwent a vastus lateralis muscle biopsy at the time of total hip or knee replacement. At the time of referral to the rehabilitation center, the Functional Independence Measure (FIM) motor score and habitual physical activity at home were evaluated, and the diameter and atrophy factor for each muscle fiber type were measured on the histopathologic preparations of the biopsied muscles. The data were analyzed using ttest, one-way analysis of variance (ANOVA), Kruskal-Wallis one-way ANOVA, Spearman's correlation coefficient, and partial correlation coefficient. The patients showed muscle fiber atrophy and small angular fibers, and the atrophy factor was significantly increased in type 1, 2A, and 2B fibers, in that order (one-way ANOVA, P < 0.05). The patterns of the fiber type atrophy, consisting of normal, type 2B atrophy, type 2AB atrophy, and type 1 and 2AB atrophy, had a significant relationship with the fiber type atrophy (Spearman's correlation coefficient; rho = 0.834, P < 0.001). The FIM motor score showed a significant correlation with the atrophy factor (r = -0.584, P < 0.05), and significant differences were recognized among the four patterns of the fiber type atrophy (Kruskal-Wallis one-way ANOVA, P < 0.05). In conclusion, the muscle atrophy and patterns of the fiber type atrophy of the vastus lateralis muscle in patients with joint disorders may be related to changes in the FIM motor score.