Concomitant Repair of Idiopathic Abductor Tears During Primary Total Hip Arthroplasty: Technique, Review and Outcomes

Abstract

This is a retrospective, consecutive, single-surgeon case series which examines the clinical and radiographic outcomes of 19 hips with the incidental finding of hip abductor tears during primary Total Hip Artroplasty (THA). The incidence of abductor tears was 0.68% during our study period from 1994 -2008. We found that positive preoperative Trendelenburg gait was a positive predictor of the presence of an abductor tear. Seven out of 19 patients had an intraoperative change in surgical approach due to the extent of the abductor tear. Bilaterality and the presence of sclerosis preoperatively were significantly associated with a longer limp period postoperatively. In conclusion, idiopathic abductor tears are rare during primary THA, however there is a high likelihood of changing the intraoperative approach if they are encountered.

Outcomes analysis of anterior and lateral approach for open repair of hip abductor tendons

“…Since they are different conditions, we applied proper statistical methodology to analyse them separately. Most published literature reports cohorts of <30 patients analysing IR or <24 cases studying THA+repairs, with a follow-up <1 year, 1,5,[14][15][16][17] and the most comprehensive series report different repair methods and outcomes. 2,6,7,18 Despite disparities, most demonstrate improvement in PROMs after IR and THA+repair, [6][7][8][9][14][15][16][17][18] which is in line with our findings.…”

“…Most published literature reports cohorts of <30 patients analysing IR or <24 cases studying THA+repairs, with a follow-up <1 year, 1,5,[14][15][16][17] and the most comprehensive series report different repair methods and outcomes. 2,6,7,18 Despite disparities, most demonstrate improvement in PROMs after IR and THA+repair, [6][7][8][9][14][15][16][17][18] which is in line with our findings. Studies reporting VAS pain scores in both groups report an average result of 1.8-2.2.…”

“…1,4 Over the last decade, studies have been published analysing gluteal tendon tears and their management. [5][6][7][8][9][10][11][12][13][14][15] There is growing evidence that where conservative treatment fails, surgical repair is an effective and safe treatment. 1,5 Nevertheless, most published studies consist of small cohorts, lack definition of the type of tears, complications, re-tears, and report follow-up periods shorter than 12 months.…”

“…Moreover, very few papers address the outcomes of patients undergoing concomitant repair and total hip arthroplasty (THA), despite a tear incidence of 25% in patients undergoing THA. 4,14 This retrospective study analyses results and predictors of outcomes such as type of tear and age for open repairs, either as an isolated procedure or simultaneously with THA. We hypothesised that surgical repair is effective and safe in both groups, and expected to find worse results in older patients, where both tendons were torn and where full-thickness tears were diagnosed.…”

“…Moreover, very few papers address the outcomes of patients undergoing concomitant repair and total hip arthroplasty (THA), despite a tear incidence of 25% in patients undergoing THA. 4,14…”