Evaluating hip disarticulation outcomes in a 51-patient series

Huffman, Allison; Schneeberger, Steven; Goodyear, Evelyn; West, Julie M.; O’Brien, Andrew; Mayerson, Joel L.; Schulz, Steven; Moore, Amy M.

doi:10.1016/j.jor.2022.04.008

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…Indications for HD include advanced malignancy, soft-tissue defects, fulminant infection, and untreatable ischemia. This procedure is relatively high-risk, with complication rates as high as 60% 9 and mortality ranging from 0% to 50%. 10 After HD, patients are reported to have severely worsened quality of life, pain measures, and survival.…”

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confidence: 99%

Vastus Lateralis Muscle Flap for High-Risk Patients Undergoing Orthopaedic Hip Surgery

Olsson,

Amado,

Fijany

et al. 2024

JAAOS Glob Res Rev

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Introduction: Chronic infections and soft-tissue defects are serious complications after total hip arthroplasties (THAs) that may require hip disarticulation (HD). HD is a relatively high-risk procedure with poor long-term outcomes and survival. This is the first study to analyze the effect of an ipsilateral, pedicled vastus lateralis (VL) muscle flap in preventing HD in patients with recurrent complications after THA. Methods: This retrospective case review analyzed the 6-month postoperative outcomes of 14 patients who underwent soft-tissue hip reconstruction with a VL muscle flap by a single surgeon. Results: Most (86%) patients fully recovered after 6 months with preserved hip range of motion, no pain, and no weakness on ambulation. Two (14%) patients ultimately required HD despite introducing a VL flap. Discussion: A VL muscle flap is an effective treatment of nonhealing THA and prophylactic intervention for patients at high risk for HD. The VL muscle is optimal because of its large size allowing reduction of soft-tissue dead space, its local anatomical location to the hip, and its exceptional vascularity. Additional prospective studies are necessary to determine the most appropriate population for this technique.

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confidence: 99%