Abductor tendon tears are associated with hypertrophy of the tensor fasciae latae muscle

Sutter, Reto; Kalberer, Fabian; Binkert, Christoph A.; Graf, Nicole; Pfirrmann, Christian W. A.; Gutzeit, Andreas

doi:10.1007/s00256-012-1514-2

Cited by 58 publications

(45 citation statements)

References 22 publications

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“…Although general atrophy of the periarticular hip muscles has been observed in end-stage osteoarthritis [7,13,14], isolated relative changes of muscle dimensions with hip pathologies are rarely reported in the literature [15,21]. One of the few reports describes a reactive hypertrophy of the tensor fascia latae muscle in hips with an ipsilateral abductor tendon tear [21]. In this study, the relative size of the cross-sectional area of the tensor fascia latae muscle was compared with the sartorius muscle.…”

Section: Discussionmentioning

confidence: 97%

An Increased Iliocapsularis-to-rectus-femoris Ratio Is Suggestive for Instability in Borderline Hips

Haefeli

Steppacher

Babst

et al. 2015

Clinical Orthopaedics &Amp; Related Research

107

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Background The iliocapsularis muscle is an anterior hip structure that appears to function as a stabilizer in normal hips. Previous studies have shown that the iliocapsularis is hypertrophied in developmental dysplasia of the hip (DDH). An easy MR-based measurement of the ratio of the size of the iliocapsularis to that of adjacent anatomical structures such as the rectus femoris muscle might be helpful in everyday clinical use. Questions/purposes We asked (1) whether the iliocapsularis-to-rectus-femoris ratio for cross-sectional area, thickness, width, and circumference is increased in DDH when compared with hips with acetabular overcoverage or normal hips; and (2) what is the diagnostic performance of these ratios to distinguish dysplastic from pincer hips? Methods We retrospectively compared the anatomy of the iliocapsularis muscle between two study groups with symptomatic hips with different acetabular coverage and a control group with asymptomatic hips. The study groups were selected from a series of patients seen at the outpatient clinic for DDH or femoroacetabular impingement. The allocation to a study group was based on conventional radiographs: the dysplasia group was defined by a lateral center-edge (LCE) angle of \ 25°with a minimal acetabular index of 14°and consisted of 45 patients (45 hips); the pincer group was defined by an LCE angle exceeding 39°and consisted of 37 patients (40 hips). The control group consisted of 30 asymptomatic hips (26 patients) with MRIs performed for nonorthopaedic reasons. The anatomy of the iliocapsularis and rectus femoris muscle was evaluated using MR arthrography of the hip and the following parameters: crosssectional area, thickness, width, and circumference. The iliocapsularis-to-rectus-femoris ratio of these four anatomical parameters was then compared between the two study groups and the control group. The diagnostic performance of these ratios to distinguish dysplasia from protrusio was evaluated by calculating receiver operating characteristic (ROC) curves and the positive predictive value (PPV) for a ratio [ 1. Presence and absence of DDH (ground truth) were determined on plain radiographs using the previously mentioned radiographic parameters. Evaluation of radiographs and MRIs was performed in a blinded fashion. The PPV was chosen because it indicates how likely a hip is dysplastic if the iliocapsularis-to-rectus-femoris ratio was [ 1.Results The iliocapsularis-to-rectus-femoris ratio for cross-sectional area, thickness, width, and circumference was increased in hips with radiographic evidence of DDH (ratios ranging from 1.31 to 1.35) compared with pincer (ratios ranging from 0.71 to 0.90; p \ 0.001) and compared with the control group, the ratio of cross-sectional area, thickness, width, and circumference was increased (ratios ranging from 1.10 to 1.15; p ranging from 0.002 to 0.039). The area under the ROC curve ranged from 0.781 to 0.852. For a one-to-one iliocapsularis-to-rectus-femoris ratio, the PPV was 89% (95% confidence interval [CI], 73%-96%)...

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Section: Discussionmentioning

confidence: 97%

An Increased Iliocapsularis-to-rectus-femoris Ratio Is Suggestive for Instability in Borderline Hips

Haefeli

Steppacher

Babst

et al. 2015

Clinical Orthopaedics &Amp; Related Research

107

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“…Kummer [35] calculated the potential for trochanteric abductor muscles to provide 70 % of the abductor force required for pelvic control in a single-leg stance, with the remaining 30 % provided by the ITB-tensing muscles. The TFL has been shown to hypertrophy [36] and GMed and GMin atrophy [18] in those with gluteal tendon pathology. The latter study assessed patients following total hip arthroplasty (THA) with and without trochanteric pain.…”

Section: Muscle Factors and Interaction With Joint Positionmentioning

confidence: 98%

Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management

Grimaldi¹,

et al. 2015

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Tendinopathy of the gluteus medius and gluteus minimus tendons is now recognized as a primary local source of lateral hip pain. The condition mostly occurs in mid-life both in athletes and in subjects who do not regularly exercise. Females are afflicted more than males. This condition interferes with sleep (side lying) and common weight-bearing tasks, which makes it a debilitating musculoskeletal condition with a significant impact. Mechanical loading drives the biological processes within a tendon and determines its structural form and load-bearing capacity. The combination of excessive compression and high tensile loads within tendons are thought to be most damaging. The available evidence suggests that joint position (particularly excessive hip adduction), together with muscle and bone elements, are key factors in gluteal tendinopathy. These factors provide a basis for a clinical reasoning process in the assessment and management of a patient presenting with localized lateral hip pain from gluteal tendinopathy. Currently, there is a lack of consensus as to which clinical examination tests provide best diagnostic utility. On the basis of the few diagnostic utility studies and the current understanding of the pathomechanics of gluteal tendinopathy, we propose that a battery of clinical tests utilizing a combination of provocative compressive and tensile loads is currently best practice in its assessment. Management of this condition commonly involves corticosteroid injection, exercise or shock wave therapy, with surgery reserved for recalcitrant cases. There is a dearth of evidence for any treatments, so the approach we recommend involves managing the load on the tendons through exercise and education on the underlying pathomechanics.

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“…The TFL also plays a distinct role in various exercises, such as kicking [3], as well as in pathologic states that require compensatory muscle actions under conditions of strain and pain [8]. The TFL is hypertrophied in patients with a tear of the gluteal tendon [15]. Thus, despite its small size, the TFL enhances the function of other muscles.…”

mentioning

confidence: 99%

Tensor fasciae latae muscle in human embryos and fetuses with special reference to its contribution to the development of the iliotibial tract

et al. 2015

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Abductor tendon tears are associated with hypertrophy of the tensor fasciae latae muscle

Cited by 58 publications

References 22 publications

An Increased Iliocapsularis-to-rectus-femoris Ratio Is Suggestive for Instability in Borderline Hips

An Increased Iliocapsularis-to-rectus-femoris Ratio Is Suggestive for Instability in Borderline Hips

Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management

Tensor fasciae latae muscle in human embryos and fetuses with special reference to its contribution to the development of the iliotibial tract

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