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Late repair of abductor avulsion after the transgluteal approach for hip arthroplasty

Dora, Claudio
Clark, John M.
Notzli, Hubert P.
Published in Journal of Arthroplasty. 2010, vol. 25, no. 3, p. 450-457 e451
Abstract The abductor release sometimes does not heal after a transgluteal approach for hip arthroplasty. Factors influencing the success of subsequent repair are unclear. We used magnetic resonance imaging (MRI) to compare the condition of the gluteus medius with clinical outcome after late repair of abductor dehiscence in 12 total hip patients. Evaluation included a pain rating, gait evaluation, Trendelenburg test, strength grading, and Harris Hip Score. Most had both prerepair and postrepair MRI studies to assess the repair and to grade abductor muscle fatty degeneration. Two repairs without MRI were explored surgically. Although average pain, limp, and strength scores improved significantly, rerupture occurred in 4 subjects and fatty degeneration in the gluteus medius did not improve, even with intact repair. Nine patients were satisfied; 7 of these had an intact repair. Magnetic resonance imaging and operative observations suggest that chronic degeneration in the abductor mechanism is the major impediment to successful repair.
Keywords AdultAgedArthroplasty, Replacement, Hip/ adverse effects/ methodsButtocksFemaleFollow-Up StudiesGait/physiologyHip ProsthesisHumansMagnetic Resonance ImagingMaleMiddle AgedMuscle, Skeletal/pathology/physiopathology/ surgeryPain/etiologyReoperationSurgical Wound Dehiscence/ etiology/physiopathology/ surgeryTreatment OutcomeWound Healing/physiology
PMID: 19282140
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Other version: http://www.sciencedirect.com/science/journal/08835403
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MIOZZARI, Hermès Howard et al. Late repair of abductor avulsion after the transgluteal approach for hip arthroplasty. In: Journal of Arthroplasty, 2010, vol. 25, n° 3, p. 450-457 e451. doi: 10.1016/j.arth.2008.12.010 https://archive-ouverte.unige.ch/unige:21144

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Deposited on : 2012-05-23

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