Late Repair of Abductor Avulsion After the Transgluteal Approach for Hip Arthroplasty

Miozzari, Hermès Howard; Dora, Claudio; Clark, John M.; Nötzli, Hubert

doi:10.1016/j.arth.2008.12.010

Cited by 89 publications

(91 citation statements)

References 36 publications

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“…In a series of nine patients from Weber and Berry [14], only one patient had an excellent result, three had good results, two were fair and three patients were considered as failures. Miozzari et al [3] in their series elaborated that only nine of their 12 patients were satisfied with the surgery. Four patients still walked with a limp and two patients had a positive Trendelenburg test.…”

Section: Discussionmentioning

confidence: 99%

“…Trans-osseous repair using nonabsorbable sutures to reattach the abductor mechanism to the greater trochanter seems to be the favoured option [3,4,[14][15][16]. Results of these procedures are unpredictable.…”

Section: Discussionmentioning

confidence: 99%

“…There have been several techniques described for repairing these abductor tears including direct trans-osseous repairs [3,4], endoscopic repair techniques [5], Achilles tendon allograft [6], gluteus maximus muscle transfers [7] and vastus lateralis muscle transfers [8,9]. The results have been unpredictable and often involve extensive recovery and rehabilitation periods.…”

Section: Introductionmentioning

confidence: 99%

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Surgical repair of hip abductors. A new technique using Graft Jacket® allograft acellular human dermal matrix

Rao

Kamal

Vafaye

et al. 2012

International Orthopaedics (SICOT)

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Purpose Avulsion of the abductors from the hip can be an infrequent but debilitating complication after total hip arthroplasty performed through a trans-gluteal approach. This can result in intractable pain, limp, Trendelenberg lurch and instability of the hip. There have been various methods described for repairing or reconstruction of this abductor muscle complex including direct trans-osseous repair, muscle transfers, muscle and tendon sling, bone tendon allograft reconstruction and endoscopic repair techniques. Methods In a prospective study at our institution we evaluated the results of a surgical technique in 12 patients using a transosseous repair of gluteus medius and minimus insertions augmented by a Graft Jacket® allograft acellular human dermal matrix (Graft Jacket®; Wright Medical Technology, Arlington, TN) over the anterior and anterolateral aspects of the greater trochanter. Diagnosis of hip abductor avulsions was made by evaluation of the history of presenting complaint, clinical examination and confirmed by ultrasound or MRI scans.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical repair of hip abductors. A new technique using Graft Jacket® allograft acellular human dermal matrix

Rao

Kamal

Vafaye

et al. 2012

International Orthopaedics (SICOT)

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“…Notably, this syndrome can present both in patients with and without total hip arthroplasty (THA), and it is commonly caused by abductor tendon abnormalities [1,[3][4][5]. In addition to severe lateral hip pain, abductor tendon tears and atrophy of the associated muscles often result in further clinical problems such as a Trendelenburg gait pattern, or immobility [6].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2012

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OBJECTIVE: To evaluate the association between hypertrophy of the tensor fasciae latae muscle and abductor tendon tears. MATERIALS AND METHODS: Thirty-five patients who underwent MRI of the abductor tendons of the hip were included in this retrospective study. A subgroup of 18 patients was examined bilaterally. The area of the tensor fasciae latae muscle and the area of the sartorius muscle (size reference) were quantified at the level of the femoral head, and a ratio was calculated. Two radiologists assessed the integrity of the gluteus medius and minimus tendon in consensus. Data were analyzed with a Mann-Whitney U test. RESULTS: Sixteen out of 35 patients (46 %) had a tear of the gluteus medius or minimus tendon. The ratio of the area of the tensor fasciae latae to the sartorius muscle was significantly higher (p = .028) in the group with an abductor tendon tear (median 2.25; Interquartile Range [IQR] = 1.97-3.21) compared to the group without any tears (median 1.91; IQR = 1.52-2.26). The bilateral subanalysis showed that in patients without a tear, the ratio of the two areas did not differ between each side (p = .966), with a median of 1.54 (primary side) and 1.76 (contralateral side). In patients with an abductor tendon tear the ratio was significantly higher (p = .031) on the side with a tear (median 2.81) compared to the contralateral healthy side (1.67). CONCLUSION: Patients with abductor tendon tears showed hypertrophy of the tensor fasciae latae muscle when compared to the contralateral healthy side and to patients without a tear. AbstractObjective. To evaluate the association between hypertrophy of the tensor fasciae latae muscle and abductor tendon tears. Materials and Methods.Thirty-five patients with MRI of the abductor tendons of the hip were included in this retrospective study. A subgroup of 18 patients was examined bilaterally. The area of the tensor fasciae latae muscle and the area of the sartorius muscle (size reference) were quantified at the level of the femoral head, and a ratio was calculated. Two radiologists assessed the integrity of the gluteus medius and minimus tendon in consensus. Data were analyzed with a Mann-Whitney U test.Results. Sixteen out of 35 patients (46%) had a tear of the gluteus medius or minimus tendon. The ratio of the area of the tensor fasciae latae to the sartorius muscle was significantly higher (p=.028) in the group with an abductor tendon tear (median 2.25;Interquartile Range [IQR]= 1.97-3.21) compared to the group without tear (median 1.91; IQR= 1.52-2.26). The bilateral subanalysis showed that in patients without a tear, the ratio of the two areas did not differ between each side (p=.966), with a median of 1.54 (primary side) and 1.76 (contralateral side). In patients with an abductor tendon tear the ratio was significantly higher (p=.031) on the side with a tear (median 2.81) compared to the contralateral healthy side (1.67). Conclusion.Patients with abductor tendon tears showed hypertrophy of the tensor fasciae latae muscle when compared to the ...

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“…15,[29][30][31] The insufficiency likely results from failure of the repaired tenotomy following a direct lateral approach, chronic degeneration of the gluteus medius tendon preoperatively, or irreparable tears at the time of THA in up to 20% of patients undergoing the procedure. 32,33 The latter point, as well as technical pitfalls, such as inadequate restoration of femoral offset, may explain why some patients undergoing primary THA …”

Section: Abductor Insufficiencymentioning

confidence: 99%

Surgical approach in primary total hip arthroplasty: anatomy, technique and clinical outcomes

Petis

Howard

Lanting

et al. 2015

cjs

312

234

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Late Repair of Abductor Avulsion After the Transgluteal Approach for Hip Arthroplasty

Cited by 89 publications

References 36 publications

Surgical repair of hip abductors. A new technique using Graft Jacket® allograft acellular human dermal matrix

Surgical repair of hip abductors. A new technique using Graft Jacket® allograft acellular human dermal matrix

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

Surgical approach in primary total hip arthroplasty: anatomy, technique and clinical outcomes

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