MRI of Failed Total Hip Replacement Caused by Abductor Muscle Avulsion

Twair, Akram; Ryan, M.; O’Connell, Martin; Powell, T.; O’Byrne, J.; Eustace, Stephen

doi:10.2214/ajr.181.6.1811547

Cited by 48 publications

(23 citation statements)

References 7 publications

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“…[57][58][59][60] Several studies have shown that metal suppression pulsed MRI sequences can identify abductor damage in patients with symptomatic abductor tears following THA. [59][60][61] Future prospective studies using MRI to assess soft tissue integrity postoperatively will provide a more objective measure of the incidence of abductor tears.…”

Section: Lateral Versus Posterior Approachmentioning

confidence: 99%

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

Petis

Howard

Lanting

et al. 2015

cjs

310

234

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Section: Lateral Versus Posterior Approachmentioning

confidence: 99%

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

Petis

Howard

Lanting

et al. 2015

cjs

310

234

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“…Spin echo sequences with high bandwidth, sequences with multiple refocusing pulses, and a frequency-encoding axis parallel to the long axis of the prosthesis are useful [87]. With such techniques, MR imaging is accurate in diagnosing abductor tendon abnormalities after THA [88,89]. It is important to realize that many MR findings, such as altered signal and diameter of the tendons, bursal fluid collection, and fatty atrophy of the anterior two-thirds of the gluteus minimus muscle, are found in asymptomatic patients, although not as frequently as in symptomatic patients.…”

Section: Abnormalities Of the Abductors Of The Hipmentioning

confidence: 99%

Hip pain in adults: MR imaging appearance of common causes

2006

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To determine the exact origin of hip pain can be challenging. Symptoms apparently originating from the hip may arise from the pelvis, the sacroiliac joint, the lumbar spine, periarticular structures such as muscles and bursae, or from unexpected sites such as the abdominal wall, the genitourinary tract, or the retroperitoneal space. This article reviews the differential diagnosis of hip pain arising from the hip and surrounding structures and the role of different imaging methods with emphasis on magnetic resonance imaging where most recent advances have occurred.

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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]. MRI is routinely used for evaluation of suspected abnormalities of the gluteus medius and minimus tendon and muscle, both in patients with and without THA, and with the routine use of MRI the knowledge about abductor tendon abnormalities has increased in recent years [3,1,2,7,8].…”

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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MRI of Failed Total Hip Replacement Caused by Abductor Muscle Avulsion

Abstract: MRI facilitates the detection of abductor muscle avulsion in patients who have undergone the anterolateral approach during total hip replacement. MRI is considered a valuable diagnostic tool when this condition is suspected.

Cited by 48 publications

References 7 publications

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

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

Hip pain in adults: MR imaging appearance of common causes

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

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