Recovery of muscular tissue and functional results of patients treated with a gluteus maximus flap transfer due to chronic abductor deficiency after total hip arthroplasty.
Abductor mechanism deficiency
Gluteus Maximus flap transfer
Total hip arthroplasty
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
03 Jul 2024
03 Jul 2024
Historique:
received:
01
02
2024
accepted:
22
06
2024
medline:
4
7
2024
pubmed:
4
7
2024
entrez:
3
7
2024
Statut:
aheadofprint
Résumé
To evaluate the function of the abductor mechanism after a gluteus maximus flap transfer due to a degeneration of the muscles after hip arthroplasty, we analyzed the post-operative functional outcome as well as radiographic effects in muscle tissue. This present study included six consecutive patients operatively treated with a gluteus maximus flap due to chronic gluteal deficiency after total hip arthroplasty. All patients presented a preoperative severe limp, hip abductor deficiency and a history of conservative treatment without the relief of symptoms. MRI scans were performed pre- and postoperatively to evaluate the muscle volume and grade of degeneration of the abductor mechanism. For clinical evaluation, the Harris hip score (HHS) was applied pre- and postoperatively. Moreover, the intensity of pain, the Trendelenburg sign, the internal rotation lag sign and the abductor muscle force were measured before and after surgery. Overall, the evaluation of the Magnetic Resonance Imaging (MRI) showed no significant changes in total muscle volume during the follow-up period. Separate measurements presented a significant growth of muscle volume for the gluteus minimus and tensor fascia lata compared to preoperative imaging during the follow-up period. The amount of fat volume decreased for all the measured muscles with statistical significance for the gluteus minimus, the gluteus medius and the tensor fascia lata. No further muscle degeneration and no flap necrosis were measured. The postoperative HHS results were not statistically significant compared to the preoperative results. Besides fair clinical results, the radiological measurements indicate that the flap transfer enables functional muscular tissue recovery and prevents further degeneration. Given these conditions, the gluteus maximus muscle flap transfer represents a viable treatment option for patients with chronic gluteal deficiency in selected patients.
Sections du résumé
BACKGROUND
BACKGROUND
To evaluate the function of the abductor mechanism after a gluteus maximus flap transfer due to a degeneration of the muscles after hip arthroplasty, we analyzed the post-operative functional outcome as well as radiographic effects in muscle tissue.
METHODS
METHODS
This present study included six consecutive patients operatively treated with a gluteus maximus flap due to chronic gluteal deficiency after total hip arthroplasty. All patients presented a preoperative severe limp, hip abductor deficiency and a history of conservative treatment without the relief of symptoms. MRI scans were performed pre- and postoperatively to evaluate the muscle volume and grade of degeneration of the abductor mechanism. For clinical evaluation, the Harris hip score (HHS) was applied pre- and postoperatively. Moreover, the intensity of pain, the Trendelenburg sign, the internal rotation lag sign and the abductor muscle force were measured before and after surgery.
RESULTS
RESULTS
Overall, the evaluation of the Magnetic Resonance Imaging (MRI) showed no significant changes in total muscle volume during the follow-up period. Separate measurements presented a significant growth of muscle volume for the gluteus minimus and tensor fascia lata compared to preoperative imaging during the follow-up period. The amount of fat volume decreased for all the measured muscles with statistical significance for the gluteus minimus, the gluteus medius and the tensor fascia lata. No further muscle degeneration and no flap necrosis were measured. The postoperative HHS results were not statistically significant compared to the preoperative results.
CONCLUSIONS
CONCLUSIONS
Besides fair clinical results, the radiological measurements indicate that the flap transfer enables functional muscular tissue recovery and prevents further degeneration. Given these conditions, the gluteus maximus muscle flap transfer represents a viable treatment option for patients with chronic gluteal deficiency in selected patients.
Identifiants
pubmed: 38960932
doi: 10.1007/s00402-024-05417-z
pii: 10.1007/s00402-024-05417-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
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